Purpose: Citation counts and journal impact factors have long been favored tools for assessing scholarly influence and informing decisions related to academic promotions and research funding. Despite their ubiquity, these measures often fail to fully capture the extent of a publication’s reach. Altmetric scores are an alternative approach focused on online engagement. The lack of studies directly comparing the most-cited articles and the highest Almetric Score articles within the field of hand surgery prevents accurate assessment of the alignment of these key career metrics. Methods: We compared the top 50 hand surgery articles by Almetric score vs. the top 50 by citation rate between January 2010, and December 2023. The total number of articles per topic was recorded, and a two-tailed Student’s t-tests was performed to determine whether differences in citations versus Altmetric scores were statistically significant (P < 0.05). Results: Articles in the high-Altmetric group had a mean Altmetric score of 67.14 (ranging from 26 to 220) and an average of 41.96 citations (range: 1 - 169). In contrast, the top-cited articles had a mean Altmetric score of 14.3 (range: 0 - 159) and an average citation count of 204.8 (range: 137 - 655). Conclusion: In hand surgery literature, the article topic significantly predicts whether research is more likely to be cited in academic circles or shared online. Patient satisfaction and opioids remain central areas of academic engagement. These findings reinforce the importance of evaluating research impact through multiple lenses, particularly in an era of evolving dissemination platforms.
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