{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:22:17Z","timestamp":1787937737265,"version":"build-2784847793"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The core clinical decision in geriatric femoral neck fracture\u2014internal fixation vs. arthroplasty\u2014has remained contested for half a century. Although landmark trials such as FAITH, HEALTH, and WHiTE 5 have profoundly reshaped clinical practice, no bibliometric study has systematically mapped the complete research architecture and knowledge evolution trajectory of this field from 1975 to the present. This study aimed to characterize the global research landscape and knowledge evolution of surgical treatment for geriatric femoral neck fracture using a tri-tool framework integrating CiteSpace, VOSviewer, and Bibliometrix with dual-database validation (WoSCC\u2009+\u2009Scopus).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The WoSCC and Scopus databases were searched in parallel on May 24, 2026, with no date restriction. WoSCC yielded 2,147 documents (1,906 articles and 241 reviews); Scopus yielded 6,019 documents (5,689 articles and 330 reviews). After DOI-based deduplication, approximately 6,592 unique records remained. WoSCC served as the primary analytical dataset, with Scopus providing independent multi-database validation. Bibliometrix was used for descriptive statistics, VOSviewer for keyword co-occurrence and country collaboration networks, and CiteSpace for keyword\/reference burst detection, co-citation clustering, and timeline analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      (1) Annual publications grew from 1 in 1975 to 203 in 2025. (2) The USA and China constitute the first-tier publishing nations (1,029 vs. 1,020 publications), yet China's average citations per article (11.5) lag substantially behind those of the United Kingdom and Sweden. (3) Bhandari M (43 publications) and Frihagen F (33 publications) were the most prolific authors;\n                      <jats:italic>Injury<\/jats:italic>\n                      was the top journal (144 publications). (4) Keyword burst analysis revealed a four-era knowledge evolution with distinct burst signatures: Foundational Era (1991\u20132001,\n                      <jats:italic>femur<\/jats:italic>\n                      26.22), Fixation Debate Era (2002\u20132013,\n                      <jats:italic>internal-fixation<\/jats:italic>\n                      15.28), Landmark Trial Era (2014\u20132018), and Perioperative Medicine Era (2019\u2013present,\n                      <jats:italic>femoral neck system<\/jats:italic>\n                      10.74). (5) The strongest citation bursts were the HEALTH trial (NEJM, strength 33.85) and Keating 2006 (JBJS Am, 29.19).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This field has undergone four paradigm shifts from biomechanical description to perioperative comprehensive management. Although China ranks among the top-tier publishing nations alongside the USA, its research paradigm must transition from technique-oriented toward patient-outcome-oriented and multicenter evidence-based approaches to bridge the persistent citation impact gap.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1894817","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:12:30Z","timestamp":1787937150000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Four eras of geriatric femoral neck fracture surgery: a bibliometric analysis of half-century research evolution and emerging frontiers"],"prefix":"10.3389","volume":"13","author":[{"given":"Da-Wei","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Shishi City Hospital","place":["Quanzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai-Ting","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shishi City Hospital","place":["Quanzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang-He","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shishi City Hospital","place":["Quanzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen-Xin","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shishi City Hospital","place":["Quanzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1007\/s00198-006-0172-4","article-title":"An estimate of the worldwide prevalence and disability associated with osteoporotic fractures","volume":"17","author":"Johnell","year":"2006","journal-title":"Osteoporos Int"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1007\/s00198-011-1601-6","article-title":"Secular trends in the incidence of hip and other osteoporotic fractures","volume":"22","author":"Cooper","year":"2011","journal-title":"Osteoporos Int"},{"key":"B3","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.injury.2004.05.023","article-title":"Complications after intracapsular hip fractures in young adults","volume":"36","author":"Damany","year":"2005","journal-title":"Injury"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1302\/0301-620X.84B8.0841150","article-title":"Hemiarthroplasty versus internal fixation for displaced intracapsular hip fractures in the elderly","author":"Parker","year":"2002","journal-title":"J Bone Joint Surg Br"},{"key":"B5","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1302\/0301-620X.85B3.13609","article-title":"Internal fixation compared with total hip replacement for displaced femoral neck fractures in the elderly","author":"Tidermark","year":"2003","journal-title":"J Bone Joint Surg Br"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1016\/S0140-6736(17)30066-1","article-title":"Fracture fixation in the operative management of hip fractures (FAITH)","volume":"389","author":"Nauth","year":"2017","journal-title":"Lancet"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2199","DOI":"10.1056\/NEJMoa1906190","article-title":"Total hip arthroplasty or hemiarthroplasty for hip fracture","volume":"381","year":"2019","journal-title":"N Engl J Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1016\/S0140-6736(20)30058-1","article-title":"Accelerated surgery versus standard care in hip fracture (HIP ATTACK)","volume":"395","author":"Borges","year":"2020","journal-title":"Lancet"},{"key":"B9","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1056\/NEJMoa2108337","article-title":"Cemented or uncemented hemiarthroplasty for intracapsular hip fracture","volume":"386","author":"Fernandez","year":"2022","journal-title":"N Engl J Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1302\/0301-620X.106B7.BJJ-2024-0267","article-title":"Causal forest analysis of the WHiTE 5 trial","author":"Bolbocean","year":"2024","journal-title":"Bone Jt J"},{"key":"B11","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1186\/s13018-021-02292-x","article-title":"Depicting developing trend and core knowledge of hip fracture research: a bibliometric and visualised analysis","volume":"16","author":"Peng","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e34003","DOI":"10.1097\/md.0000000000034003","article-title":"Research hotspots and trends in internal fixation of femoral neck fractures from 2010 to 2022: A 12-year bibliometric analysis. 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