Who Is Publishing in Hand Surgery?: A Citation Analysis Across Specialties over Five Decades

Introduction: Hand surgery continues to be practiced by general surgeons, plastic surgeons, and orthopedic surgeons. It is expected that a well-trained hand surgeon will be proficient in both bone/joint procedures as well as soft tissue/microsurgical procedures.  Despite this unified goal, training of hand surgery largely happens in plastic and orthopedic surgery departments where there are significantly different case volume and practice patterns for trainees¹. How this affects academic productivity in hand surgery is less clear. The goal of this study is to analyze the peer-reviewed hand literature over the past five decades to examine major shifts regarding which specialties are publishing papers, and the journals in which those papers are being published.

Methods: The top fifty cited articles for each decade from the 1970s to the 2010s were identified for the topic of hand surgery using the Thomson/Reuters Web of Knowledge. Data collected included: total citations per article, primary author specialty affiliation (Plastic, Orthopedic Surgery, General, Hand, other, or not reported), and the specialty affiliation of the journal. Data was plotted graphically and trends were analyzed.

Results: With regards to first authorship, plastic surgery had an equal or greater proportion of the top 50 articles compared to orthopedic surgery in the 1970s and 80s, while orthopedic surgery had a higher proportion from the 1990s-2010s (Figure 1). Orthopedic journals were the most common platform for publication of articles in the 1970s, with hand surgery journals being the most common platform from the 1980s onward (Figure 2).

Conclusion: Plastic surgeons and plastic surgery journals have declined in their presence in academic hand surgery when looking at absolute percentage while hand specialty specific and orthopedic surgeons have grown. The growing prominence of hand surgery journals mirrors the political ideology of hand surgery as a specific discipline. If our goal is to continue including hand surgery as part of the repertoire of a plastic surgeon, we as a specialty need to continue to strive for high quality academic productivity.