<![CDATA[Closed long bone fractures require a complex healing process involving inflammation and callus formation. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been proposed as potential biomarkers in the fracture healing process. To analyze the correlation between NLR, PLR, and hard callus formation in patients with a single closed long bone fracture. This retrospective cohort study involved 42 patients treated at RSUP H. Adam Malik Medan from January 2023 to December 2025. Patients were divided into a hard callus group (n=27) and a non-hard callus group (n=15) based on six-month radiological evaluation. Baseline neutrophil, lymphocyte, and platelet counts, NLR, PLR, and radiological findings were collected from medical records. Radiological findings were assessed by comparing the initial radiographs with those obtained at the six-month follow-up to evaluate callus formation. No significant differences in hematological parameters were found between the two groups (p > 0.05). Neither NLR (p = 0.694) nor PLR (p = 0.581) showed a significant association with hard callus formation. Logistic regression and ROC analysis also demonstrated low predictive ability for both NLR (AUC 0.537) and PLR (AUC 0.448). NLR and PLR are not associated with hard callus formation and have limited predictive value for bone healing in closed long bone fractures.]]>
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