SIGN's Story

SIGN's mission began in 1968 while founder and president of SIGN, Lewis G. Zirkle, Jr., M.D., served as an army orthopaedic surgeon in Vietnam. During his tour of duty, he spent much of his spare time treating Vietnamese civilians, as civilian medicine had all but ceased to exist during the war. Dr. Zirkle's concern for medical care in Southeast Asia continued after his tour of duty.

Over the next three decades, Dr. Zirkle made numerous trips to Vietnam and other developing nations to assist local health care providers in devising more effective and successful surgical techniques for treating fractures. In the 1980s, he invested a great deal of time and effort in training surgeons in Indonesia, and establishing four teaching centers. Through his efforts, the number of trained orthopaedic surgeons in that country grew from one to more than 50. Dr. Zirkle moved on to assist surgeons in other developing nations.

Some years later, on his return to Indonesia, he found surgeons eager to learn new techniques and who had great surgical skills. Implants to fix fractures, however, were not available to utilize these skills for patients with fractured legs.

Based on his experience in Indonesia, Dr. Zirkle realized that teaching alone was not enough. It was evident that ongoing education, communication, and a reliable supply of implants and other surgical materials must be made available for improved fracture treatment to succeed.

Creation of SIGN
Working with like-minded physicians, surgeons, and concerned citizens, Dr. Zirkle laid the ground work for his vision of providing an all-encompassing system of training, hardware, follow up and repeat visits to orthopaedic surgeons in developing countries. These would become the guiding principals by which all SIGN projects would be established.

SIGN was officially incorporated in January of 1999. The processes were set in place to begin projects.

In May of 1999, Dr. Zirkle traveled to Southeast Asia to initiate four SIGN "pilot projects" in public hospitals--one each in Thailand and Indonesia, and two in Vietnam. He assisted in numerous surgeries to train the partnering physicians in the techniques. A set of donated implants and their corresponding instruments were provided for each project.  These four pilot projects laid the foundation for further, ongoing partnerships in other parts of the world.

By the end of the year, SIGN had grown from one staff member to eight, including manufacturing and administrative personnel, and SIGN's first products were being manufactured by state-of-the-art machining equipment.

SIGN Today
Today, SIGN has numerous corporate partnerships and employs more than 35 people. SIGN's state-of-the-art manufacturing facility for manufacturing the SIGN IM Nail system includes an intramedullary nail, interlocking screws and instrumentation. The system is specifically designed for use in hospitals in developing countries where real time imaging and power equipment are not available. Currently, SIGN engineers are designing new implants to address a broader range of fractures in the femur and tibia.  Notable example of recent developments include a "pediatric nail" that is usable in children's trauma, not previously possible in cases where bones are still growing.

SIGN, now a First Responder in major world disasters (egs. Indonesian Tsunami, Afghanistan & Haiti Earthquakes) has nearly 300 surgery programs throughout the developing world. More than 5,000 SIGN surgeons use the SIGN system to repair fractures largely caused by road traffic crashes. Since 1999 nearly 170,000 patients have been treated with the SIGN system. As SIGN continues to spread throughout the developing world and to broaden the fixation devices offered, it is holding fast to its vision of creating equality of fracture care throughout the world.