Simultaneous submission of manuscripts to multiple journals violates established publication ethics and may compromise the integrity of the peer-review process. However, data on temporal trends, geographic distribution, and outcomes of such practices remain limited. This study aimed to address the following questions: 1) Has the frequency of simultaneous submissions increased over time? 2) Is this practice geographically concentrated or globally distributed? 3) What publication outcomes and metrics characterize these manuscripts?

We hypothesized that simultaneous submissions have increased over time and are associated with unfavourable publication outcomes.

A retrospective bibliometric study was conducted including all manuscripts submitted to Orthopaedics & Traumatology: Surgery & Research (OTSR) between 2019 and 2025. In total 60 simultaneous submissions were identified between 2019 and 2025 using editorial management systems and similarity screening tools. Data collected included year of submission, country of origin, publication status, time to publication, journal impact factor, and open access status. Temporal trends were analysed using linear regression, and descriptive statistics were applied.

A total of 60 simultaneous submissions were identified, increasing from 3 cases in 2019 to 22 cases in 2025. We observed a significant upward trend, corresponding to an annual rise of approximately 3.5 cases and an incidence increase of 0.4% per year. Geographic distribution was heterogeneous, and incidence rates adjusted for total submission numbers did not reveal a clear regional pattern. Overall, 36.7% (22/60) of manuscripts were not published. Among the 38 published manuscripts, only 15% (9/60) were accepted by one of the initially targeted journals (however 0 in OTSR which systematically desk rejected due to ethical violation), while the majority were published in different journals. Publication delays were common, with 55.3% (21/38) of manuscripts published after more than 4 months. Most manuscripts were ultimately published in journals with similar or lower impact factors, and 68.4% (26/38) appeared in fully open access journals.

Simultaneous submission appears to be an increasing and globally distributed phenomenon driven by systemic pressures to publish. However, this strategy is largely ineffective, often resulting in delayed publication, lower-impact outcomes, or failure to publish altogether, while exposing all co-authors to ethical risks. Strengthening cross-publisher collaboration and reinforcing adherence to ethical guidelines are essential to mitigate this practice.

IV; bibliometric retrospective research.