Calcium, bone spurs, and Dupuytren contracture
Calcium plays a complex role in Dupuytren contracture. Dissolved calcium is used by cells to contract. This is true for muscles to contract and for Dupuytren to cause contracture. Although calcium is involved, it’s not the cause of Dupuytren disease. Abnormally low or high levels of calcium may cause serious health problems, but Dupuytren disease is not one of them.
Bone spurs are a common problem with a variety of causes, including chronic inflammation, osteoarthritis (very common), and chronic high mechanical stress. Medical names include calcific tendinitis, osteophyte, traction osteophyte, heterotopic ossification, and others. Bones remodel and recontour continuously in response to a person’s health and activity. Sometimes bone remodeling results in pointy contour change on Xrays and are called bone spurs. Bone spurs are generally the effect, not the cause, and unless they pose a specific problem can be safely left alone.
Rarely, bone spurs develop in Dupuytren cords. They are thought to come from the bone, an effect of traction on the surface of the bone. It’s been reported a few times:
https://dupuytrens.org/DupPDFs/1987_Andrew.pdf
https://dupuytrens.org/DupPDFs/2011_Sadideen.pdf
These are examples of bone spurs/cord calcifications in Dupuytren patients. In each of these, the origin of the spur is the palm base of the middle finger bone.
Example 1.
Example 2.
Example 3.
Example 4. Before and after needle aponeurotomy. Xray shown is after release.
Example 5. Before and after needle aponeurotomy showing separation of the calcified segments.
Example 5. Needle aponeurotomy with progressive improvement over the following six weeks. Hand photographs are pre-release, one week post-release, and six weeks post-release. Xrays are pre-release and six weeks post-procedure
And a surgery video of Prof. Dr. Bert Reichert removing a Dupuytren cord calcification: