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Related Experiment Video

Updated: Oct 27, 2025

Dissection, MicroCT Scanning and Morphometric Analyses of the Baculum
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The Comma Sign: An Anatomic Study.

Dinesh Dhanaraj, Brian Cable, Connor G Hoge

    Orthopedics
    |July 22, 2021
    PubMed
    Summary

    The comma sign, composed of the coracohumeral ligament (CHL) and superior glenohumeral ligament (SGHL), is roughly 54% SGHL and 46% CHL. This anatomical landmark aids surgeons in subscapularis tendon repair.

    Area of Science:

    • Orthopedic Surgery
    • Anatomy
    • Biomechanical Research

    Background:

    • The "comma sign" is an anatomical landmark at the superolateral edge of the subscapularis tendon insertion.
    • It comprises the coracohumeral ligament (CHL) and superior glenohumeral ligament (SGHL).
    • Accurate definition of its composition is crucial for subscapularis tendon repair.

    Purpose of the Study:

    • To precisely define the composition and dimensions of the comma sign.
    • To clarify the proportional contribution of the CHL and SGHL within the comma sign.
    • To provide anatomical data aiding surgeons in subscapularis repair.

    Main Methods:

    • Dissection of 8 fresh frozen cadaveric shoulder specimens.
    • Measurement of CHL, SGHL, and subscapularis insertion widths using digital calipers.

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  • Calculation of mean widths and proportional composition of the comma sign.

    • Main Results:

    • The comma sign comprises approximately 54% SGHL and 46% CHL.
    • The mean composite width of the comma sign at the subscapularis insertion is approximately 1 cm (9.93 mm).
    • Mean widths were SGHL: 5.99 mm and CHL: 5.13 mm.

    Conclusions:

    • The comma sign is composed of roughly equal parts SGHL and CHL.
    • Understanding these dimensions is vital for arthroscopic subscapularis repairs.
    • This knowledge assists surgeons in differentiating the comma sign and restoring native anatomy.