Comparison of neurohormone and callus volume formation in long bone fractures associated with or without traumatic brain injury

BACKGROUND Fracture healing is a dynamic process influenced by systemic and local factors. Traumatic brain injury (TBI) has been clinically associated with accelerated bone repair, yet the underlying biochemical mechanisms remain unclear. AIM To investigate the roles of growth hormone (GH), parathyroid hormone (PTH), and interleukin-6 (IL-6) in callus formation among patients with long bone fractures, comparing cohorts with and without TBI. METHODS A prospective analytical study was conducted at JIPMER from January 2023 to December 2025. Patients with diaphyseal long bone fractures were stratified into two groups: With TBI and without TBI. Serum levels of GH, PTH, and IL-6 were measured at defined intervals using the enzyme-linked immunosorbent assay. Callus volume was assessed radiologically via computed tomography imaging at 4 weeks and 6 weeks post-injury. Statistical analysis included RMANOVA and correlation studies to evaluate biomarker trends and their association with callus formation. RESULTS Patients with concomitant TBI exhibited significantly elevated levels of GH and PTH during early healing phases, while IL-6 levels showed a complex temporal pattern. Callus volume was markedly higher in the TBI group at both 4 weeks and 6 weeks, with statistically significant differences (P < 0.05). Positive correlations were observed between GH/PTH levels and callus volume, whereas IL-6 showed inverse associations in certain phases. CONCLUSION TBI appears to modulate systemic hormonal and cytokine responses that favor enhanced osteogenesis. Elevated GH and PTH levels may contribute to accelerated callus formation, while IL-6’s role remains context-dependent. These findings offer potential therapeutic insights for improving fracture healing outcomes.