Disruption in Wrist Literature: Identifying Paradigm-Shifting Publications.

PURPOSE: Research in wrist surgery has advanced considerably, yet objective metrics of innovation remain limited. The disruption index (DI) offers a quantitative framework to identify papers that redirect scientific attention toward new directions, which traditional bibliometrics may overlook. Within this framework, this study aimed to examine trends in disruptive research over time. We hypothesized that DI would not correlate with citation count.

METHODS: A retrospective bibliometric analysis was performed using PubMed with wrist-specific search terms and limited to 14 selected orthopedic and wrist surgery journals. Each article was matched to its respective disruption scores in the publicly available Harvard Dataverse data set. Statistical analyses included descriptive statistics and Pearson correlation. Temporal, authorship, and journal-level patterns were evaluated, and the top 10 most disruptive publications were identified.

RESULTS: A total of 4,138 wrist-related publications were identified and included in the analysis. Disruption scores were narrowly distributed around zero, with a mean of -0.008 ± 0.042, and were weakly associated with total citation counts (r = 0.049, P < .002). The most innovative research surfaced in the 1950s (DI = 0.071) and 1960s (DI = 0.044), with scores trending toward zero over time. The journal with the highest mean DI was Clinical Orthopaedics and Related Research (DI = -0.0027). The most disruptive publication was "Management of Fractures of the Greater Multangular. Report of Five Cases," (DI = 0.857), which received only eight citations. Among the top 10 most disruptive papers, the mean DI was 0.44 ± 0.16, with an average citation count of 134.7 ± 202.5 and an average of 1.8 ± 1.2 authors.

CONCLUSIONS: This study applied the DI to wrist surgery literature. These findings provide new insight into how the field has progressed over time and suggest continued opportunities to pursue innovative, paradigm-shifting research.

TYPE OF STUDY/LEVEL OF EVIDENCE: Retrospective cohort study III.