Medlar Conor, Kilkenny Conor J, Davey Martin S, Farooq Fahad, O'Daly Brendan J
Department of Orthopaedic Surgery, Tallaght University Hospital, Tallaght, Dublin 24, Ireland.
SUNY Upstate Medical University, Syracuse, NY, USA.
J Orthop. 2025 Jan 16;67:88-93. doi: 10.1016/j.jor.2025.01.025. eCollection 2025 Sep.
Femoral shaft fractures (FSF's) represent common orthopaedic injuries, traditionally resulting from high-energy trauma in younger patients. Effective treatment is crucial for functional recovery, with significant social and economic implications. Despite extensive literature relating to FSF's, the quality of evidence and research trends remain unclear.
A bibliometric analysis was conducted using Web of Science (August 2024) to identify the top 50 most-cited publications related to FSF's. Publications were screened using specific inclusion and exclusion criteria, focusing on primary FSF-related research. Data including authorship, publishing institution, level of evidence (LOE), and study focus were analysed using VOSviewer software to explore bibliometric coupling, co-citation relationships and keyword co-occurrences.
The 50 most-cited publications collectively received 9796 citations, with the highest cited paper accumulating 508 citations. Treatment outcomes (50 %) and epidemiology (32 %) were the predominant study focuses, while only 4 % addressed surgical techniques. Retrospective cohort and case-control studies constituted 84 % of the included papers, predominantly of level III evidence. The mean patient age was 37.96 years, with a majority being female (65.2 %). Hannover Medical School emerged as the most prolific institution, and the Journal of Bone and Joint Surgery published the highest number of articles. Co-occurrence analyses highlighted trends in osteoporosis and bisphosphonate-related FSFs.
FSF literature has expanded, focusing primarily on treatment outcomes and epidemiological risk factors. However, a significant proportion of studies are of low evidence, with limited prospective research and an underrepresentation of topics such as FSF complications and paediatric fractures. Future studies should aim to maximise research quality and address emerging themes, including gender-specific analyses and the management of atypical fractures in elderly male populations.
股骨干骨折（FSF）是常见的骨科损伤，传统上多见于年轻患者的高能创伤。有效的治疗对于功能恢复至关重要，具有重大的社会和经济意义。尽管有大量关于FSF的文献，但证据质量和研究趋势仍不明确。
使用Web of Science（2024年8月）进行文献计量分析，以确定与FSF相关的被引次数最多的前50篇出版物。使用特定的纳入和排除标准对出版物进行筛选，重点关注原发性FSF相关研究。使用VOSviewer软件分析包括作者、出版机构、证据水平（LOE）和研究重点等数据，以探索文献计量耦合、共被引关系和关键词共现情况。
这50篇被引次数最多的出版物共获得9796次引用，被引次数最高的论文累计被引508次。治疗结果（50%）和流行病学（32%）是主要的研究重点，而仅4%涉及手术技术。回顾性队列研究和病例对照研究占纳入论文的84%，主要为III级证据。患者平均年龄为37.96岁，大多数为女性（65.2%）。汉诺威医学院是发文量最多的机构，《骨与关节外科杂志》发表的文章数量最多。共现分析突出了骨质疏松症和双膦酸盐相关FSF的趋势。
FSF的文献有所增加，主要集中在治疗结果和流行病学危险因素上。然而，相当一部分研究证据质量较低，前瞻性研究有限，FSF并发症和儿童骨折等主题的研究较少。未来的研究应旨在提高研究质量并解决新出现的主题，包括性别特异性分析和老年男性人群非典型骨折的管理。
