1 Introduction

Tibial plateau fractures (TPFs) are prevalent and intricate intra-articular injuries that disrupt articular surface integrity, frequently induce extensive soft tissue damage, and markedly contribute to knee dysfunction and post-traumatic osteoarthritis.^1–3 The incidence of TPFs has been demonstrating an upward trend, accounting for approximately 2 % of all skeletal fractures. These fractures predominantly affect two distinct patient demographics: young individuals sustaining high-energy injuries (e.g., traffic accidents) and elderly patients experiencing low-energy trauma (e.g., fragility fractures from simple falls).⁴ These fractures impose significant socioeconomic burdens owing to the complexities of treatment, prolonged rehabilitation periods, and substantial healthcare expenditures.⁵ Therefore, exploring optimal and effective management strategies is essential to improve the prognosis of TPFs and facilitate functional recovery.

Surgical intervention constitutes the primary treatment modality for TPFs, aiming to restore articular surface integrity, achieve rigid fixation, facilitate early rehabilitation, and ultimately restore pre-injury function.^6,7 However, optimal surgical strategies remain controversial and are influenced by numerous factors.⁸ Critical considerations encompass fracture morphologies and patterns, surgical approaches, operative timing, implant selection, adjunctive technologies (e.g., imaging, navigation, assisted-reduction device), bone defect management, soft tissue handling, and postoperative rehabilitation protocols.^9–12 These multifaceted challenges underscore the complexity inherent in achieving consistently favorable outcomes. Despite extensive research on various aspects of TPFs, a comprehensive knowledge of the broader research landscape, encompassing its evolution, current research hotspots, emerging frontiers, and key knowledge gaps, remains elusive. This deficiency may hinder the integration of fragmented knowledge and interdisciplinary communication, and potentially slow the overall progress of the field. Identifying core research themes and predicting future directions is thus crucial for guiding focused investigations, optimizing resourcing allocation, and fostering integration.

Bibliometric analysis provides a powerful quantitative methodology for mapping research landscapes, visualizing knowledge networks, identifying collaborative patterns, and predicting emerging trends in scientific disciplines.^13,14 By analyzing publication data, this approach enables researchers to intuitively grasp the intellectual structure, evolutionary trajectory, and focal points of a field. Bibliometric analysis has been successfully applied to multiple subspecialties within orthopedics, including stem cell therapy for rotator cuff injuries and spinal cord injuries, as well as the relationship between extracellular vesicles and osteoarthritis.^15–17 However, bibliometric analysis remains underutilized in the specific domain of TPFs. Consequently, this study employs this methodology to map the global research landscape of TPFs from 2000 to 2025 to systematically analyze publication trends, collaborative relationships, citation networks, thematic shifts, and research frontiers. We hypothesize that this analysis will: 1) Unveil critical research hotspots and frontiers. 2) Provide clinicians and researchers with a comprehensive framework to understand the evolution of knowledge and identify priority areas for future investigation. 3) Serve as a foundational resource to enhance the understanding of TPF pathogenesis, therapeutic evolutions, and foster interdisciplinary collaboration.

2 Materials and methods

2.1

2.1 Data acquisition and screening

A systematic literature search was conducted on June 1, 2025, accessing the Web of Science Core Collection (WOSCC) database. Publications indexed between January 1, 2000, and June 1, 2025, were targeted to capture a comprehensive 25-year span of the research landscape. The search strategy utilized Boolean Logic operators (OR) to combine key terms related to TPFs: TS = (“tibial plateau fracture∗” OR “fracture, tibial plateau” OR “bicondylar tibial plateau fracture∗” OR “medial tibial plateau fracture∗” OR “lateral tibial plateau fracture∗”). This query was designed to ensure broad coverage of relevant publications. The detailed process of document retrieval and screening is depicted in Fig. 1. Following a stringent screening process, a total of 1546 publications, comprising 1427 research articles and 119 review articles, were ultimately included in the final bibliometric analysis. All enrolled documents were exported from WOSCC in plain text format, preserving full records (including titles, authors, affiliations, abstracts, keywords, journals, publication years, and funding sources) and all cited references. This comprehensive dataset provided the foundation for subsequent quantitative and visualization analyses.

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Fig. 1 Flowchart of literature retrieval and screening for bibliometric analysis.

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3 Results

3.1

3.1 Global publication trends

A total of 1546 publications (1427 articles and 119 reviews) on TPFs were identified, demonstrating a significant upward trend in research output (Fig. 2). The continuous growth in annual publication volume not only reflects the academic community's growing attention to and in-depth research on TPFs, a persistent therapeutic challenge in orthopedics, but also indicates that extensive academic inquiry is advancing the understanding of TPFs' pathogenesis and the optimization of therapeutic approaches.

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Fig. 2 Annual publication output and cumulative publications on TPFs.

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3.2

3.2 Contributions of countries, institutions, journals, and authors

A total of 69 countries contributed to TPF research, with the top 15 most productive nations listed in Table 1 and visualized in Fig. 3A according to publication volume. The United States took the lead in both productivity (475 publications, accounting for 30.7 %) and total citations (14,275). China ranked second in productivity (366 publications, 23.7 %) but accumulated fewer citation impact (4639 total citations). Notably, high-impact research predominantly originated from developed economies; the United Kingdom and Canada achieved the highest average citations per paper (47.58 and 44.17, respectively). A complex international collaboration network structure was illustrated in Fig. 4D and E, where the United States and China possess the most extensive collaboration network, followed by Germany, the United Kingdom, and Canada.

Table 1 Publications of the top 15 most productive countries and institutions.

Country	Documents	Citations	aACs	Rank	Institutions	Counts	Citations	aACs
United States	475	14,275	30.05	1	Hebei Medical University	56	1871	33.41
China	366	4639	12.67	2	Shanghai Jiao Tong University	35	306	8.74
Germany	130	3189	24.53	3	NYU	29	287	9.90
United Kingdom	106	5044	47.58	4	University Utah	28	925	33.04
Netherlands	60	1575	26.25	5	University Med Cen Ham-Epp	27	424	15.70
India	57	274	4.81	6	Wenzhou Medicine university	24	444	18.50
Canada	53	2341	44.17	7	Hospital Special Surgery	23	429	18.65
France	45	709	15.76	8	University Maryland	21	431	20.52
Switzerland	38	1297	34.13	9	Royal Adelaide Hospital	18	814	45.22
Australia	37	867	23.43	10	Tongji University	18	248	13.78
Italy	34	807	23.74	11	University of Adelaide	17	392	23.06
Turkey	32	528	16.50	12	University of Minnesota	16	394	24.63
Brazil	31	598	19.29	13	University of Toronto	16	864	54.00
South Korea	28	495	17.68	14	University Calif San Francisco	15	1315	87.67
Belgium	26	306	11.77	15	University of Missouri	15	564	37.60

a Acs: average citations.

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Fig. 3 Distribution of bibliometric information by countries, institutions, journals, and authors. (A) The top 15 countries by publication output. (B) The top 15 institutions by publication output. (C) The top 15 journals by publication output. (D) The top 15 authors by publication output.

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Fig. 4 Network visualization map of institutions, journals, authors, countries, and funding support in TPF research. (A) The cooperative network map of institutions. (B) The co-network visualized map of journals; (C) The co-network visualized map of authors. (D, E) The complex international collaborations map among different countries. (F) Top 15 funding organizations.

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A total of 1817 institutions have contributed to TPF-related publications. As listed in Table 1 and illustrated in Fig. 3B, Hebei Medical University of China ranked as the most productive institution (56 publications), followed by Shanghai Jiao Tong University (35 publications) and New York University (29 publications). Among these, Hebei Medical University also received the highest total citations (1871), whereas the University of California, San Francisco achieved the highest average citations (87.67). Fig. 4A visualizes collaboration relationships among institutions, where the width of the connecting lines represents the intensity of collaboration. Hebei Medical University, Shanghai Jiao Tong University, and Tongji University demonstrated strong collaborative relationships.

A total of 258 journals published TPF-related research, with the top 15 most productive journals in this field listed in Table 2. Injury-International Journal of the Care of the Injured (JCR: Q3, IF: 2.0) led with 166 publications, followed by the Journal of Orthopedic Trauma (152 publications) and the International Orthopedics (54 publications). Notably, Journal of Orthopedic Trauma (JCR: Q2, IF: 1.8) boasts the highest citations (7783) and the third highest average citations (51.20), signifying its substantial influence and recognition within the TPF research community. In comparison, the Journal of Bone and Joint Surgery-American Volume (JCR: Q1, IF: 4.3) achieved the highest average citations (80.52), reflecting the superior quality and academic impact of the research it publishes. Among the top 15 journals, approximately 26.7 % are classified as JCR Q1 and Q3, with the remainder belonging to the Q2 category. Furthermore, Fig. 4B presents journal co-occurrence network maps featuring three primary thematic clusters. It demonstrates that journals with higher production output typically maintain more collaborations than those with lower productivity.

Table 2 The top 15 contributing journals.

Rank	Journals	Counts	IF (2024)	JCR	Citations	aACs
1	Injury-International Journal of the Care of the Injured	166	2.0	Q3	4209	25.36
2	Journal of Orthopedic Trauma	152	1.8	Q2	7783	51.20
3	International Orthopedics	54	2.6	Q2	1065	19.72
4	Knee	51	2.0	Q2	1029	20.18
5	BMC Musculoskeletal Disorders	50	2.4	Q2	441	8.82
6	Journal of Orthopedic Surgery and Research	50	2.8	Q1	590	11.80
7	Archives of Orthopedic and Trauma Surgery	50	2.1	Q2	980	19.60
8	Journal of Knee Surgery	45	1.6	Q3	589	13.09
9	Knee Surgery, Sports Traumatology, Arthroscopy	43	5.0	Q1	979	22.77
10	European Journal of Trauma and Emergency Surgery	40	2.2	Q2	348	8.70
11	European Journal of Orthopedic Surgery and Traumatology	37	1.5	Q3	86	2.32
12	India Journal of Orthopedics	31	1.1	Q3	197	6.35
13	Cureus Journal of Medical Science	28	1.3	Q2	34	1.21
14	Clinical Orthopedics and Related Research	27	4.4	Q1	1563	57.89
15	Journal of Bone and Joint Surgery-American Volume	25	4.3	Q1	2013	80.52

a Acs: average citations.

A total of 6352 authors have contributed to TPF-related scientific literature. The top 15 most productive authors are presented in Table 3, and their collaborative relationships are visualized in Fig. 4C. Among these prolific authors, Zhang Yingze leads in publication volume, with 38 articles and a total of 455 citations (Acs: 11.97). Egol Kenneth A ranks second with 35 articles and 451 total citations (ACs: 12.89). Luo Congfeng, with 25 publications, stands out with both the highest cumulative citations (1125) and the highest average citations (45.00). Visualization of the co-authorship network reveals four distinct key clusters, each comprising 26 authors with a minimum of 10 publications. The largest cluster, shown in blue, is centered on Zhang Yingze. The second-largest cluster, in red, revolves around Egol Kenneth A. The third cluster, in yellow, is anchored by Luo Congfeng, and the fourth cluster, in purple, is centered on Krause Matthias.

Table 3 The top 15 contributing authors and the top 15 keywords.

Author	Publications	Citations	aACs	Rank	Keywords	Occurrences	Total link strength
Zhang Yingze	38	455	11.97	1	Tibial plateau fracture	1012	2941
Egol Kenneth A	35	451	12.89	2	Internal fixation	621	2297
Chen Wei	27	359	13.30	3	Surgery	377	1480
Luo Congfeng	25	1125	45.00	4	Open reduction	279	1203
Ronsch Karl Heinz	21	614	29.24	5	Knee	221	820
Haller Justin M	20	198	9.90	6	Classification	214	852
Zhu Yanbin	19	323	17.00	7	Complications	169	698
Krause Matthias	18	425	23.61	8	Outcomes	137	541
Higgins Thomas F	17	239	14.06	9	Risk	109	474
Solomon Lucian B	16	433	27.06	10	Osteoarthritis	100	330
Gardner Michael J	15	240	16.00	11	Schatzker	91	374
Konda Sanjit R	14	104	7.43	12	Follow-up	91	385
Hoekstra Harm	14	133	9.50	13	Osteotomy	90	276
Giordano Vincenzo	13	294	22.62	14	Total knee arthroplasty	84	331
Hou Zhiyong	13	95	7.31	15	CT	78	327

a Acs: average citations.

3.4

3.4 Reference co-citation, clustering network map, and burst value

Co-citation analysis of the literature reveals that multiple documents are frequently co-cited in subsequent studies, thereby reflecting their relevance to specific research themes or methodologies and contributing to the uncovering of underlying knowledge frameworks, identification of research hotspots and trends, facilitation of academic exchange and collaboration, and evaluation of academic influence. Fig. 5A illustrates the publication timeline of these co-cited references, detailing their respective first authors. Specifically, Fig. 5B displays eight distinct clusters derived from the reference dataset, with “bicondylar tibial plateau fracture” as the most prominent research focus. These clusters are categorized into three content-based panels: Panel 1 emphasizes various TPF patterns, including “bicondylar tibial plateau fracture”, “hyperextension bicondylar”, and “posteromedial fragment”; Panel 2 focuses on treatment and prognosis, covering aspects such as the “fibular-head approach”, “different fixation”, “tibial plateau fixation”, and “surgical site infection”; and panel 3 highlights the value of animal studies and diagnostic examinations, particularly those utilizing the “rabbit model”. Notably, an increase in citation frequency within a specific timeframe indicates heightened academic attention to the corresponding topic, thereby signifying the emergence of research hotspots and trends. Fig. 5C shows the top 25 references exhibiting the strongest citation bursts, where red bars indicate a significant surge in citations and the blue bars denote a moderate increase. Among these, Kfuri M (2018, Injury) exhibits the highest citation burst strength (26.67), followed by Luo CF (2010, Journal of Orthopedic Trauma, burst: 17.03), and Xie XT (2020, Journal of Bone and Joint Surgery, bursts: 15.41).^20–22 These studies collectively underscore the critical role of CT imaging in TPF classification, demonstrating its capacity to effectively overcome the limitations inherent in the X-ray-based classification. Additionally, it provides clinicians with more detailed information to understand injury mechanisms, thereby optimizing preoperative planning and decision-making, and ultimately improving patient prognosis.

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Fig. 5 Bibliometric analysis of references co-citation (A) Co-cited references with authors. (B) Co-cited references clusters. (C) Top 25 cited references with the strongest citation bursts in tibial plateau fracture research.

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3.5

3.5 Keyword co-occurrence, clustering network, burst value, and timeline distribution

Keyword co-occurrence analysis effectively illustrates and captures the direction and trends of TPF academic research. From the 1546 retrieved documents, a total of 3887 keywords were extracted, among which 58 appeared more than 25 times. The top 15 high-frequency keywords are presented in Table 3, with “tibial plateau fracture” identified as the most prominent (co-occurrence frequency 1012, total link strength: 2941), followed by “internal fixation” (621, 2297), “surgery” (377, 1480), and “open reduction” (279, 1203). Fig. 6A visually represents a keyword co-occurrence network map featuring four distinct clusters, organized around the core keywords: “tibial plateau fracture, internal fixation, surgery, and outcomes”. A high keyword occurrence value typically indicates strong academic interest, cutting-edge research, and potential future research directions. Furthermore, Fig. 6B illustrates six distinct keyword clusters categorized into three thematic categories: fracture characteristics (#1 posterolateral tibial plateau fracture, #5 Schatzker classification), treatment methods (#3 systematic review, #4 bone graft substitute), and prognosis outcomes (#2 long-term functional outcome, #0 compartment syndrome). Fig. 6C presents the top 25 keywords with the highest emergence intensity, highlighting that their occurrence frequency and burst trends are crucial for predicting future research directions. The five keywords exhibiting the strongest citation bursts are “external fixation (burst strength:10.22, time frame: 2002–2010), tibial plateau fractures (8.48, 2009–2012), follow-up (8.11, 2009–2019), condylar fractures (7.58, 2003–2009), and experience (7.46, 2007–2015). Notably, since 2020, keywords exhibiting the strongest citation bursts include trauma (5.26), Schatzker classification (6.55), finite element analysis (7.02), osteoarthritis (5.19), surgical site infection (5.13), and compartment syndrome (4.67). Furthermore, the keyword timeline plot (Fig. 6D) further illustrates temporal variations in frequency, indicating the collaborative connections between keywords, shifts in research intensity, and emerging future directions.

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Fig. 6 Bibliometric analysis of keywords (A) Keyword co-occurrence network visualization. (B) Thematic clusters of keywords co-occurrence. (C) Top 25 keywords with the strongest citation bursts. (D) Distribution characteristics of keywords timeline in TPFs.

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4 Discussion

Tibial plateau fractures (TPFs) are highly challenging orthopedic injuries involving the articular surface and are frequently accompanied by severe soft tissue damage. These injuries can result in joint destruction, knee dysfunction, and substantial healthcare burdens.^23,24 Driven by an aging global population and an increase in traffic-related injuries, the incidence of TPFs has been escalating.²⁵ In recent years, in-depth investigations into TPFs have elucidated their injury mechanisms and fracture patterns. These advancements have consequently promoted progress in surgical techniques, facilitated the development of compatible implants, and optimized strategies for preoperative planning and postoperative rehabilitation guidance.^26,27 Analyzing the publication timeline and developmental trends offers valuable insights into the evaluation and advancement of research focus within this field over time. Against this backdrop, our bibliometric analysis provides a detailed overview of the global TPF research landscape, systematically identifying key trends, research hotspots, and emerging focus areas.

Over the past two decades, global research output on TPFs has shown a significant upward trend. This trend not only reflects the academic community's growing attention to TPFs but also aligns with the clinical urgency driven by the injury's inherent complexity and the pressing need for optimized treatment strategies. The United States and China have emerged as the primary contributors, accounting for over half of the total global publications. Their leading position stems from robust research funding, access to advanced technological resources, and extensive international collaboration networks. However, a clear disparity in research quality exists between the two nations: while the US leads in both publication volume and citation impact, China exhibits substantially lower citation influence despite ranking second in publication quantity, as indicated by the average citation per paper (China: 12.67; United States: 30.05). This quality gap may be attributed to differences in funding models and collaborative patterns. In the US, research funding is diversified (including NIH, HHS, and industry partnerships) and prioritizes long-term basic research (encompassing TPF injury mechanisms, biomaterial development, and internal devices) and interdisciplinary collaboration, thereby enhancing the originality and global relevance of their findings. In contrast, China's research leans more towards clinical application (such as surgical technique optimization, surgical approach, and fracture classification), and its collaboration networks remain predominantly domestic, which limits deep partnerships with leading international research teams and reduces visibility and influence within global academic circles.

Countries such as the United Kingdom and Canada, though not leading in publication volume, exhibit the highest average citation rates. This underscores their commitment to high-quality and impactful research, further emphasizing that citation influence aligns more closely with research depth and originality than sheer output quantity. These disparities highlight potential gaps in research priorities, funding allocation, technical support, and international collaboration between developed and developing nations. To advance global TPF research collectively, it is crucial to foster inclusive global collaborations, particularly with developing countries that manage a relatively high number of TPF cases. Additionally, optimizing funding structure and strengthening academic exchange platforms can help bridge the “quantity to quality” divide and drive more equitable, impactful progress in TPF research.

Institutional contribution analysis shows that the top 15 most productive entities in TPF research have published 358 articles (23.2 % of total), with institutions from China and the United States dominating this leading group. Specifically, institutions such as China's Hebei Medical University and Shanghai Jiao Tong University, alongside the United States' New York University and the University of Utah, rank among the most prolific. Notably, these top-performing institutions have established robust collaborative networks, encompassing both domestic partnerships and international linkages. Such collaborative frameworks are critical for pooling resources, sharing expertise, and addressing complex research questions, all of which are essential for advancing TPF research. Enhancing collaboration among these leading institutions could further accelerate the development of innovative treatment strategies, optimize clinical decision-making, and ultimately improve patient outcomes.

Within the realm of TPF research, the top 15 most influential journals include Injury, Journal of Orthopedic Trauma, Journal of Bone and Joint Surgery, and Clinical Orthopedics and Related Research. These publications collectively function as primary conduits for disseminating high-quality research findings and facilitating academic exchange. Among them, Journal of Orthopedic Trauma stands out with the highest publication counts, and Journal of Bone and Joint Surgery boasts the highest average citations, a metric reflecting its authoritative standing and international influence. These leading journals not only act as key platforms for sharing cutting-edge TPF research and evidence-based clinical practices but also underscore a critical insight for researchers: publishing in high-impact journals enhances the visibility and accessibility of research outcomes, thereby maximizing their potential to inform global clinical decision-making and drive progress in TPF diagnosis and treatment. The top 15 most cited publications in TPF research concentrate on “fracture classification”, “surgical treatment”, “bone grafting”, “postoperative complications”, and “function recovery”. These themes fully cover the entire continuum of TPF management, from diagnosis and treatment to postoperative care and prognosis, providing clinicians with valuable evidence-based guidance for standardized clinical practice.

At the author level, Zhang Yinze is the most prolific contributor (38 publications, 11.97 average citations), while Luo Congfeng boasts the highest total (1125) and average citations (45.00), reflecting their profound academic impact and contributions to this field. More specifically, Zhang Yingze pioneered the “double reverse traction repositor” assisted reduction technology and its corresponding device.^28,29 He further emphasized the importance of preventing and managing surgical site infections in TPF treatment.³⁰ Luo Congfeng proposed a 3DCT-based three-column classification, which effectively overcame the limitations of the traditional Shatzker classification.^21,31 Moreover, he developed the “three-column fixation” concept, validated by in-depth analysis of TPF injury mechanisms. This concept provides direct and actionable guidance for clinical surgical approaches and the selection of internal fixation methods.³² Additionally, his research on hyperextension varus TPFs and posterolateral complex injuries has bridged a cognitive gap in the academic community's understanding of TPF-related soft tissue injuries.^33,34 Notably, Zhang Yingze has also made substantial contributions beyond academic papers. He has conducted extensive training programs on TPF management and delivered specialized lectures at various conferences, cultivating a large number of orthopedic professionals. This practical promotion of TPF knowledge and techniques further amplifies the influence of Chinese scholars in this field. Moreover, encouraging deeper collaboration among these top authors (both domestically and internationally) can further accelerate the development of new techniques, optimize clinical protocols, and ultimately improve the global standard of care.

The reference co-citation visualization map illustrates the influence of publications: each node represents a single reference, with node size proportional to its citation frequency, and connecting lines between nodes indicating shared citation relationships among related articles. The most frequently cited reference was authored by Kfuri M. in 2018 in Injury.²⁰ This study revised the traditional Schatzker classification using CT-based anatomical columns (lateral and medial) and quadrants (anterior and posterior) segmentation. This revised classification system enables precise localization of TPFs, providing clear guidance for clinical preoperative planning, surgical approach selection, and implant determination. Clusters in the map align with the highly cited reference, focusing primarily on fracture classification, treatment strategies, and animal research that optimize preoperative protocols, standardize treatment processes, and improve prognosis. The citation bursts map highlights the top five references with the strongest citation bursts: Kfuri M (2018, burst strength: 27.67), Luo CF (2008, 17.03), Barei DP (2004, 15.92), Xie XT (2020, 15.41), and Krause M (2016, 15.22). Their surging citation reflect pivotal contributions to TPF research frontiers, such as advancing precision classification and surgical technique innovation.^{20–22,35,36}

In terms of keywords, the top five demonstrating high burst intensity are “external fixation” (strength 10.22), “tibial plateau fractures” (8.48), “follow up” (8.11), “condylar fractures” (7.58), and “knee” (7.43), suggesting their prominence as foundational research themes.²³ Analysis of keyword frequency and timeline plot reveals a notable shift in research focus over time, with growing attention in recent years directed towards terms such as “risk factor”, “trauma”, “finite element analysis (FEA)”, “osteoarthritis”, “surgical site infection”, and “compartment syndrome”.³⁷ TPFs with high-energy trauma from traffic accidents and construction injuries usually accompany severe soft tissue damage or compartment syndrome, posing complicated therapeutic challenges and frequently leading to suboptimal outcomes.^38,39 Finite element analysis (FEA) bridges the gap between theoretical research and surgical practice by enabling computer-simulated evaluation of TPF biomechanics. For example, FEA can simulate stress distribution across the tibial plateau under various fixation strategies, predict risks of implant loosening or failure, optimize surgical planning, reduce intraoperative uncertainty, and guide rehabilitation protocols.^40,41 Compartment syndrome, surgical site infection, and risk factors highlight a critical shift toward prioritizing perioperative complication management. These focus areas have garnered significant attention and emphasis, leading to effective reduction in the occurrence of complications such as limb dysfunction and infection, thereby substantially improving prognosis.

Additionally, the growing emphasis on “osteoarthritis” and “elderly patients with osteoporosis” reflects the field's recognition of the importance of considering long-term prognosis and age-related challenges. To ensure favorable outcomes, clinicians are encouraged to adopt individualized management strategies for TPFs. These strategies include using bone graft substitutes for reconstructing bone defects, integrating anti-osteoporosis therapies, and designing structured long-term follow-up protocols to monitor and mitigate joint degeneration.^42,43 Collectively, these trends underscore that current TPF research is becoming increasingly aligned with real-world clinical needs, particularly in enhancing surgical precision, reducing complications, and improving long-term outcomes.

5 Conclusion

The bibliometric analysis can offer a novel perspective for scholars to understand the landscape of TPFs, enabling systematic organization of basic theoretical knowledge, the precise identification of research hotspots, and the in-depth exploration of future research directions. This bibliometric and visualization analysis demonstrated that the United States and China are internationally forefront leaders in this field, with the Journal of Orthopedic Trauma and Injury identified as the core journals for related studies. Novel imaging technologies prove invaluable for analyzing injury mechanisms and fracture types, assisting surgeons in preoperative assessment, treatment decision-making, and prognosis evaluation. To advance this research further, enhancing collaboration and academic exchanges among authors, institutions, and nations is essential.

Author contribution

Xiong Wang: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Validation, Visualization, Writing-original draft, Writing -review & editing.

Zhi Zhang: Data curation, Formal analysis, Investigation, Investigation, Methodology, Writing-original draft.

Lu Li: Conceptualization, Investigation, Data curation, Formal analysis, Writing-original draft.

Qing Gu: Conceptualization, Data curation, Investigation, Writing-original draft, Writing-review & editing.

Shuming Zi: Conceptualization, Data curation, Formal analysis, Investigation, Supervision, Writing-original draft, Writing-review & editing.

Ethical statement

The content of this article does not deal with the content of ethical review.

Guardian Patient's consent

All authors agreed to the publication of the article.

Funding

This work is supported by the Science and Technology Commission of Baoshan District, Shanghai, China (2024-E−43), Funded by Baoshan District Health Commission Excellent Youth (Yucai) Program (BSWSYC-2024-17).