The SIGN network is like a machine moving steadily toward creating equality of fracture care throughout the world. Each part symbolizes SIGN staff, surgeons, volunteers and donors who all rely on each other as SIGN implants are used to treat increasing numbers of patients in developing countries.
I see the results of SIGN surgery on the database every day when I am in the U.S. The comments on the database by surgeons in developing countries often express new ideas and new indications for SIGN implants. The x-rays demonstrate the process of fracture healing and the pictures of the patients squatting and smiling have been shown to demonstrate fracture healing better than the x-rays. We realize the smile is not quantitative but smiles are contagious as an expression of joy and appreciation.
These are patients who would have severe disability due to their fractures if their surgeons were not excellent surgeons and did not have access to SIGN implants. These surgeons understand fracture principles and enthusiastically treat their fellow countryman without using sophisticated equipment.
Our generous donors are essential to the network as the number of SIGN programs and different implants increases. We are like a big family.
- Lewis J. Zirkle, M.D.
Working with like-minded surgeons, engineers and concerned citizens, Dr. Zirkle laid the groundwork for a comprehensive model of building orthopaedic capacity overseas by combining implants and instruments, and training that would equip surgeons in developing countries to treat trauma victims. The vision became a reality in January 1999 when SIGN Fracture Care International was officially incorporated as a nonprofit corporation in the State of Washington.
The concept for SIGN evolved more than 40 years ago when the founder and president of SIGN, Lewis G. Zirkle, MD, was serving as an army orthopaedic surgeon in Vietnam. In addition to treating military personnel, he treated the crippling injuries of Vietnamese civilians and developed a compassionate concern for their health needs.
Over the next forty years, Dr. Zirkle made numerous trips to Vietnam and other developing nations where he assisted local doctors in developing successful techniques for fracture treatment. In the 1980s, he helped to expand Indonesia’s orthopaedic program from 4 residents to 50 by traveling there annually to provide training and donated implants to the handful of hospitals involved in training orthopaedic residents.
Years later he returned to Indonesia to discover a patient who had lain in traction for 3 years. He was dismayed to learn that the surgeons he spent 10 years training had not been able to sustain a quality orthopaedic program because they did not have sufficient supplies of orthopaedic implants and hardware. At that sentinel moment he realized that training must be accompanied with a sustainable supply of relevant implants and instrumentation. He took a photo of the patient lying in bed as a reminder of the commitment he made to change his training model. That photo of ‘the man in the bed’ now hangs on the walls at SIGN to remind us of our commitment to provide a sustainable supply of effective implants in conjunction with relevant training.