In February 2018, Dr. Zirkle was honored with the Department of Defense Medal for Distinguish Public Service, presented by Secretary of Defense James Mattis

Intramedullary (IM) Nailing underwent many designs and iterations during the 20^th Century. However, technological advancements made modern IM Nailing exclusive to high-income countries. People in low- and middle-income countries (LMIC) don’t have the same access to hospitals, orthopaedic specialists, and implants needed to care for fractures.

The construction of the SIGN Bioskills Lab was a milestone in SIGN's history. The lab offers SIGN Surgeons an opportunity to practice surgical techniques on human tissue, under the guidance of mentors. Training received in the Bioskills Lab equips SIGN Surgeons to train their colleagues and care for patients in their own communities.

Over the years, SIGN’s disaster response has evolved from traveling to from the US to provide patient care into empowering local doctors to be first responders using the SIGN Technique.

In order to provide implants for more than 430,000 people over the last 25 years, we have continually refined and expanded our manufacturing equipment and processes.

If there is a secret that explains how SIGN has succeeded in supporting surgeons and helping more than 425,000 people heal over 25 years, it just might be the SIGN Surgical Database.

Treating a patient’s injury is important, but the biggest value that SIGN provides is what the surgery enables each patient to do. Most SIGN Patients with a fracture are able to stand and walk with crutches one day after surgery, leave the hospital within one week, and return to work or school in one month.

Throughout this year, we will be looking back at the people and events that have inspired this journey as a means to celebrate, to re-affirm our mission to create equality of fracture care throughout the world, and to guide our path for the next 25 years and beyond.