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. 2022 Feb 19;43(6):984–1002. doi: 10.1210/endrev/bnac008

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Figure 2. — Intramembranous ossification and endochondral ossification occur in parallel, but with different underlying mechanisms. Whereas periosteal mesenchymal stem cells (MSCs) adjacent to the fracture site form a hard callus via intramembranous ossification, the central area with a hypoxic core forms a soft callus via endochondral ossification. The macrophages are M2-polarized and alternatively activated (AAM), and the role of chondrocytes in the soft callus development becomes more prominent. Created with BioRender.com.