The 100 most impactful articles in foot and ankle surgery: An altmetric analysis.

Citation count and impact factor of the publishing journal are two historically utilized metrics to determine an article's impact in its research field. However, these metrics are limited given the rise in research dissemination through social media. Across other orthopedic specialties, the Altmetric Attention Score (AAS) has been used to determine which articles are most impactful. This study utilizes the AAS to highlight the 100 most impactful articles in foot and ankle surgery and determine if bibliometric factors and article characteristics are predictive of AAS. The AAS website was queried on a single day in September 2024 and 4,262 articles were retrieved. The top 100 relevant foot and ankle articles published after 2010 were ranked by AAS and analyzed for bibliometric factors, study design, and study subject. The median (IQR) AAS was 18 (14, 42.5). A majority of the top 100 impactful articles were published in the Journal of Foot and Ankle Surgery and Foot and Ankle Surgery. Most articles were original clinical research articles (54 %). Facebook and news mentions were positively correlated with AAS (p = 0.019, p < 0.0001, respectively) while other social media mentions had no significant relationship (p > 0.05). Study design and study subject were not significant predictors of AAS (p > 0.05). In conclusion, our study finds that, while citation count indicates an article's longitudinal impact, it does not correlate with AAS in foot and ankle surgery, which provides an immediate, dynamic metric to directly compare articles' impacts. Level of Evidence: Level IV.