Development and Growth of Bone

The primitive embryonal skeleton consists of cartilage and fibrous tissue, in which the bones develop. The process is termed ossification or osteogenesis, and is effected essentially by bone-producing cells, called osteoblasts. It is customary, therefore, to designate as membrane bones those which are developed in fibrous tissue, and as cartilage bones those which are preformed in cartilage. The principal membrane bones are those of the roof and sides of the cranium and most of the bones of the face. The cartilage bones comprise, therefore, most of the skeleton. Correspondingly we distinguish intramembranous and endochondral ossification.

In intramembranous development the process begins at a definite center of ossification where the cells (osteoblasts) surround themselves with a deposit of bone. The process extends from this center to the periphery of the future bone, thus producing a network of bony trabeculæ. The trabeculæ rapidly thicken and coalesce, forming a bony plate which is separated from the adjacent bones by persistent fibrous tissue. The superficial part of the original tissue becomes periosteum, and on the deep face of this successive layers of periosteal bone are formed by osteoblasts until the bone attains its definitive thickness.

In endochondral ossification the process is fundamentally the same, but not quite so simple. Osteoblasts emigrate from the deep face of the perichondrium or primitive periosteum into the cartilage and cause calcification of the matrix or ground-substance of the latter. Vessels extend into the calcifying area, the cartilage cells shrink and disappear, forming primary marrow cavities which are occupied by processes of the osteogenic tissue. There is thus formed a sort of scaffolding of calcareous trabeculæ on which the bone is constructed by the osteoblasts. At the same time perichondral bone is formed by the osteoblasts of the primitive periosteum. The calcified cartilage is broken down and absorbed through the agency of large cells called osteoclasts, and is replaced by bone deposited by the osteoblasts. The osteoclasts also cause absorption of the primitive bone, producing the marrow cavities; thus in the case of the long bones the primitive central spongy bone is largely absorbed to form the medullary cavity of the shaft, and persists chiefly in the extremities. Destruction of the central part and formation of subperiosteal bone continue until the shaft of the bone has completed its growth.

A typical long bone is developed from three primary centers of ossification, one for the diaphysis or shaft and one for each epiphysis or extremity. Many bones have secondary centers from which processes or apophyses develop.

The foregoing outline accounts for the growth of bones except in regard to length. Increase in length may be explained briefly as follows: Provision for continued ossification at either end of the diaphysis is made by a layer of actively growing cartilage—the epiphyseal cartilage—which intervenes between the diaphysis and the epiphysis. It is evident that so long as this cartilage persists and grows, new bone may continue to be formed at its expense, and increase of length is possible. When the epiphyseal cartilage ceases to grow, it undergoes ossification, the bone is consolidated, and no further increase in length is possible. This fusion takes place at fairly definite periods in the various bones, and it is of value to know the usual times at which it occurs in the larger bones of the limbs at least.

After the bones have reached their full size, the periosteum becomes relatively reduced and inactive so far as its osteogenic layer is concerned; the bone-forming function may be stimulated by various causes, as is well seen in the healing of fractures and the occurrence of bony enlargements.