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Updated: Jun 15 2021

Intramembranous Bone Formation

  • Introduction
    • One of the two essential processes during
      • development formation
      • fracture healing
      • also commonly known as contact healing, and Haversian remodeling
    • Physiology
      • occurs without a cartilage model (unlike enchondral ossification)
    • Examples of intramembranous ossification
      • embryonic flat bone formation (skull, maxilla, mandible, pelvis, clavicle, subperiosteal surface of long bone)
      • distraction osteogenesis bone formation
      • blastem bone (occurs in children with amputations)
      • fracture healing with rigid fixation (compression plate)
      • one component of healing with intramedullary nailing
    • Associated conditions
      • conditions with defects in intramembranous ossification
        • cleidocranial dysplasia
          • caused by defect in intramembranous ossification
          • caused by mutation in CBFA1 (also know as Runx2) located on chromosome 6
  • Mechanism
    • Steps of intramembranous bone formation
      1. aggregation of undifferentiated mesenchymal cells
      2. osteoblast differentiation
      3. organic matrix deposition
    • Regulation and signaling
      • controlled by pathway called canonical Wnt and Hedgehog signaling
        • beta-catenin enters cells and induces cells to form osteoblasts which then proceed with intramembranous bone formation
        • important transcription factors include CBFA1 (also know as Runx2) and osterix (OSX)
        • sclerostin, created by the SOST gene, decreases bone mass by inhibiting the Wnt pathway
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