International Orthopaedics

, Volume 43, Issue 7, pp 1567–1572 | Cite as

Haematology panel biomarkers for humeral, femoral, and tibial diaphyseal fractures

  • Luchian Alexandru
  • Horia HaragusEmail author
  • Bogdan Deleanu
  • Bogdan Timar
  • Dan V. Poenaru
  • Daliborca Cristina Vlad
Original Paper



The neutrophil to lymphocyte ratio (NLR) is a simple predictor used in oncology and cardiology. We aimed to analyze the NLR profile of patients with diaphyseal fractures of the humerus, femur, and tibia.


We performed a cross-sectional, consecutive-case population-based study including 148 patients (41.9% men respectively 58.1% women) with humeral (23.0%), femoral (30.4%), and tibial (46.6%) diaphyseal fractures, admitted for surgical treatment in our level 1 trauma centre over two years.


The differences in NLR between the studied subgroups were not significant (p = 0.067), the highest value being observed in patients with femoral fracture (5.6) in contrast to patients with humeral fracture (4). In the global cohort, there was a significantly positive correlation between NLR and PLR (platelet to lymphocyte ratio; Spearman’s r = 0.595; p < 0.001). The stratified subgroup analysis found significant association between NLR and duration of admission only for patients with femoral fracture (Spearman’s r = − 0.308; p < 0.001). When compared with controls, all three fracture types had significantly higher neutrophil numbers and NLR and lower thrombocyte numbers.


NLR are elevated in femur diaphyseal fractures compared with tibia and humerus, up to cut-off values with negative prediction of outcome in malignancy and cardiovascular patients. Increased NLR are predictive of longer hospital admissions for femur fractures.


Neutrophil to lymphocyte ratio Inflammation Fracture Femur Tibia Humerus 



The authors acknowledge Dr. Andrei Gheorghitoiu.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  1. 1.Spitalul Clinic de Ortopedie FoișorBucharestRomania
  2. 2.‘Victor Babes’ University of Medicine and PharmacyTimisoaraRomania
  3. 3.Department of Orthopedics and Trauma‘Victor Babes’ University of Medicine and PharmacyTimisoaraRomania
  4. 4.Functional Sciences“Victor Babes” University of Medicine and PharmacyTimisoaraRomania
  5. 5.Department of Pharmacology‘Victor Babes’ University of Medicine and PharmacyTimisoaraRomania

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