SIGN Fracture Care International

My husband and I have been volunteering at SIGN for quite a few years. We are also regular donors. We do this because we believe that their work makes lasting improvements in people's lives around the world and promotes development of local medical personnel who continue that work. We also believe in the integrity of the people who manage and develop the SIGN programs.

SIGN Fracture Care goes above and beyond as an organization.

SIGN Fracture Care is an outstanding organization. Both the staff at SIGN and the surgeons they support are wonderful people. More importantly, I love to see that they use their donations wisely and responsibly, with an overwhelming majority (close to 90%) going directly to their surgeons and programs. Dr. Zirkle and SIGN truly care about people in need.

SIGN Fracture Care International gave me a tour of their facility and explained what they do. They answered questions and showed in depth their projects and how the doctors they train use their tools to perform implant surgeries on fractured bones. They were innovative and passionate about helping people, always trying to find ways to make their patients experiences better and to treat more types of injuries.

They explained everything so well and was very interesting.

What a wonderful Mission!!
This is such a wonderful nonprofit organization. Thousands of people get medical attention that they would never be able to afford without Dr. Zirkle’s vision and humanitarian efforts.

Excellent caring long term staff are all very invested in the longevity of the organization.

SIGN makes a huge difference in the ability for our rural hospital to care for the fractures that arrive at our facility. They not only provide excellent materials but their constant review of our follow up xrays and outcomes provides a really helpful quality control.

Life-Changing Orthopedic Care: A Tribute to SIGN Fracture Care


"I've had the privilege of collaborating with SIGN Fracture Care, and their dedication to providing exceptional orthopedic care is truly inspiring. Their innovative approaches, cutting-edge techniques, and commitment to education have transformed the lives of countless patients worldwide.


The SIGN team's passion for improving fracture management is contagious, and their impact extends far beyond the operating room. From comprehensive training programs to accessible, high-quality implants, SIGN Fracture Care embodies excellence in orthopedic care.


Key strengths:


- Innovative solutions for complex fractures
- Expert training and education
- Accessible, high-quality implants
- Compassionate, patient-centered approach
- Global outreach and community engagement


If you're seeking exceptional orthopedic care or seeking to elevate your practice, look no further than SIGN Fracture Care. Their tireless efforts have earned them a reputation as leaders in the field, and I'm honored to support their mission.


*Highly recommended!*"

SIGN has changed the lives of thousands of people in low resource settings. It’s incredible!

SIGN does a tremendous jobadressing the global epidemic of road traffic accidents by providing orthopedic implants for long bone fractures and education and training for surgeons in the developing world. The implants are provided free of charge.

This is my favorite nonprofit by far. Surgeons from all over the world were just here last week for training that all takes place in North Richland. I cannot understand why this is not in our local news. This was my 4th year of volunteering for them, which is now my favorite activity to do. Myself and other Kiwanians offer our services to drive them to various shopping places in the evenings. This gives me a chance to learn more about their country and culture. Since I love to travel to foreign countries and talk to people from different backgrounds, it is right up my alley. Stories that the doctors have told me about their patients, clinics, and hospitals clearly show me how much SIGN is needed. This is truly a humanitarian organization that helps people all over the world who are in desperate need.

My husband and I knew Dr. Zirkle from the his practice in the local medical community. When he could have retired, he chose instead to direct his energy toward helping others. His dedication to helping others is reflected in the values of SIGN. What is powerful is seeing how a whole new community of orthopedic surgeons around the world has grown out of this. We've enjoyed supporting SIGN as volunteers and donors over the years - this is an amazing example of a great non profit.

We've known Dr. Zirkle and his family since he began working in his garage at home on the project that became SIGN. He has been a great mentor for so many surgeons, including our son John. When John went to Liberia on a five year medical mission, Dr. Zirkle taught him the SIGN Method and sent him a set of instruments and implants to treat patients at his hospital. This program is still going strong today thanks to the continued support of SIGN.

We knew Dr. Zirkle during his residency at Duke University Hospital and reconnected with him after we moved to Richland years later. Before he started SIGN, he would collect donated orthopedic equipment to take back to Vietnam every year. We helped him with these efforts then, and have continued to support the work of SIGN since the beginning. Helping SIGN also helps bring peace and goodwill because everything is donated with no strings attached.

I appreciate the availability of the SIGN group. Each question I have, the team gives me an answer. After my training I was alone in my hospital, the only surgeon. I wrote to Dr. Zirkle and every time he gave me advice and instruction. It seems like I'm with my family. People are kind and gentle with me.

In addition, the nails you give us work so well, and every time we need them, you give more. You help us to help our population. Thank you SIGN for all of this

Top notch organization that in my opinion provides the "best value" for any time or money donated.
They are highly motivated and very organized. Extremely impactful in this world. I can not think of any other organization that provides: Education, Clinical Research, Basic Science Research, Medical manufacturing, Shipping/handling/Logistics. Not to mention design and development of medical implants!

What more could one ask for?
Dr. Parham Rasoulinejad

SIGN is an incredible program and I am so fortunate to be a part of this family. Dr. Zirkle and the SIGN team have made such a profound international impact and the annual conference really inspires me to be a better surgeon and to give back. SIGN provides us with the opportunity to do so. The bioskills lab is the highlight of the conference for me, where we get to learn together with the SIGN surgeons and develop our surgical skillset. The connections I make every year at the conference makes me a better surgeon. I am really grateful to SIGN and can't wait for next year's conference.

I have been a volunteer for nearly 20 years. I cannot think of a charity that has had a greater impact on the world trauma scene. Every penny is accounted for and those suffering from fractures are treated free in 54 developing countries around the world. Implants- education- treatment.

I am a sign surgeon who benefited from the SIGN support and has changed the life of my hopsital and all my patients. It was not only receiveing the nail but the edicational path was amazing and has empowered my skill to a level that I could not immagine.

SIGN will always hold a special place in my heart. It's more than just an implant - it's a family, a community of people around the world that share the same vision: to promote equality of fracture care around the world. Anyone who breaks a bone that is repairable and needs to be repaired should have the ability to provide for their family, go to school, or even simply walk without regard to what circumstances they happen to have been born in. SIGN lets them to that - not just by providing them with a device that lets their bones be fixed in a way very similar to the high tech care given in higher income countries, but also by providing their nearest surgeon who treats broken bones with the training and ongoing communication to use these tools. SIGN is also not about knowledge just going one way; it is a multidirectional conduit of information, where those in high, middle, and low income countries, those treating patients with few or with many resources, all share information with each other, teach each other, and learn from each other - all for the goal of improving patient care one broken bone at a time, and equalizing the care of their fracture regardless of where they live. We're up to 300,000 lives changed so far, and counting!

I have worked with SIGN for over 12 years as an instructor at the annual conference, a board member for 5 years. I have led deformity correction courses and mentorships internationally in Africa and the Philippines. SIGN has created a network of thousands of surgeons worldwide that provide crucial orthopaedic trauma care to hundreds of thousands of people in lower and middle income countries. The benefits of SIGN are incredible and far reaching in saving limbs and lives.

The number of people with disabilities in our community has been reduced, because SIGN nails help people heal properly from a fracture.

SIGN has helped build our careers as surgeons. SIGN has partnered with us and stood the test of time. For research, they give us the opportunity to learn new techniques and learn to treat more patients.

At our hospital, we teach young surgeons. If you don't have implants to treat fractures, you have nothing. You can't teach without the tools. SIGN provides the tools and resupplies the implants to help us care for patients and teach new surgeons.

With SIGN, you can operate anywhere. You don’t need to depend on a C-arm in the operating room.

SIGN helps surgeons treat complicated fractures. It's good for surgeons and patients.

The network of surgeons around the world is incredibly valuable. If you have patients with difficult cases, you can find someone who has a solution to the same problem.
The SIGN Conference is the best. I have learned so many skills that I am taking home to treat my patients.

SIGN Fracture Care brought joy and happiness to thousands of families around the world by simply combining education with implant donation. Their capacity to connect people makes the world a better place. Dr. Zirkle accomplishes his vision by providing so much care for those in austere environments. I'm honored to be part of this great organization, as it is truly worthwhile.

If you want bang for your charitable buck , this is the organization for you. So much life saving assistance is given for so little administrative cost. Put your dollars to work to serve the world, not administrators.

I met Dr. Zirkle at an AAOS meeting. I was extremely impressed with his candor and kindness. I came to learn what a difference SIGN has made in the quality of life for so many people.

As an Orthopedic surgeon, it made so much sense to support his organization. The very idea of manufacturing the implants, providing education and distributing them throughout the world was inspiring. There was no doubt that the energies and efforts were immeasurable (philosophical and philanthropic).

Marc Appel, M.D.

SIGN is an amazing organization that has truly made an difference around the world. I have been involved since SIGN started and have seen the gratitude and impact that this organization has had on patients, surgeons and families. SIGN is constantly looking to expand both the number of patients that we can treat and the types on injuries that we can support. Surgeries in developing countries can be more challenging due to both a lack of supplies and the number and severity of many of the injuries. SIGN's model of designing and making the right implants, intensive surgeon training and building a sense of family with our partners has been the key to reaching the people who need us the most.

The SIGN Fracture Care organization is amazingly innovative in their approaches to optimizing both the extensive updating of Orthopaedic surgeons’ education around the world, as well as the instrumentation and fracture /trauma care that they provide, for those surgeons to use. On-line conferences and courses, which are available world wide, incorporate both the finest of surgeons in North America, as well as local international surgeons, in this process. The new SIGN Spine initiative, demonstrates the continual desire present, to expand in the breadth of their core fracture care mission, by now, starting to address some of the most complex and challenging aspects of trauma, that potentially devastating spinal injuries can entail.

SIGN Fracture Care is one of the most effective service models in the world. By building capacity of local surgeons and supplying what they need- equipment and education, they humbly lead the world to greater mobility.

A unique global organization that supports the local, in-country, surgeons with supplies and education so that they can treat their patients. SIGN designs, manufactures, and ships much needed trauma and deformity products to help those most in need with leg, arm, pelvis fractures. It has been an privilege to support and donate and see all the patients walking again.

From the perspective of a former employee:
SIGN is bold in its mission and caring for all people, both around the world and the employees at the main headquarters in Richland, WA.
I had the privilege of preparing 1,000's of nails - and other tools - to be sent out around the world. We were constantly reminded of the bigger picture of why we do what we do. To be flooded with stories of healing and families restored all around the world created a strong motivation to continually give my best. I was trained well and had clear expectiations. SIGN was a place where I could learn, grow and excel. Being reminded that we each play an important role in this mission is very compelling and energizing, and also very unusual in this world. Thank you SIGN for the good work you do both around the world and for the employees/staff at SIGN.

Dr. Zirkle and his team have a tremendously positive impact on families and children around the world. S.I.G.N is a class act!

I am a retired physician and long term SIGN supporter and fund raiser. SIGN--FRACTURE CARE INTERNATIONAL is the dream made real by Dr. L. Zirkle and his supporters. The dream is Equality of Fracture Care throughout the World. The reality was created by providing
EDUCATION + IMPLANTS to achieve HEALING. The SIGN team teaches local surgeons who can then share their knowledge. The Richland SIGN non-profit manufacturing plant provides the surgical intra-medullary nails to stabilize fractures, allowing them to heal. To date, 386 hospitals in 54 countries have used SIGN nails to heal 361,490 patients and save their dependents from poverty. The success of the project is dependent on the education, equipment, and continued vision that Equality of Fracture Care throughout the world is possible. I know of no other international medical project that is so successful. The final element necessary for success is DONATION to support SIGN. That way you can be a part of SIGN just as I am. Emily K. Citron, member of the Bellingham Kiwanis Club

I have seen first hand the great work SIGN surgeons are doing around the world. They are true humanitarians. I am honoured to support such a great organization that treats the poor.

My husband and I have been supporters of Sign for many years. The mission of Sign is to teach local surgeons in areas of the world with limited resources how to use Sign’s surgical implants and to donate all instruments and implants without charge. For more than twenty years Sign has followed this mission and expanded their reach to the under served populations of the world; as of today they provide training and equipment to 385 hospitals in 55 countries. As a result of the extensive network of surgeons they have trained and the equipment provided, Sign surgeons have been able to respond quickly when natural disasters strike, such as the August 14, 2021 earthquake in Haiti. The expansion of Sign could not have been done without the dedication and hard work of the Sign leadership and team members who are dedicated to providing equality of fracture care throughout the world. This is an organization we are proud to support.

SIGN Fracture Care International surgeons repair broken bones of poor patients in developing countries. SIGN educates these surgeons, and manufactures and donates the orthopaedic equipment and implants. Traveling to Cambodia and the Philippines with SIGN surgeons, and being in the operating room as they repaired severely fractured bones using the SIGN implant, I was able to more fully comprehend SIGN's important mission to educate surgeons and treat the injured poor. I've seen the despair of injured patients with no money to pay for surgery. When the surgeon told them the implants would be donated by SIGN and they would soon walk again, the patients' joy was palpable. I listened as SIGN surgeons studied and discussed the day's plan to provide the best care for their patients. When the patient is the family breadwinner, the lack of medical care will sink the family deeper into poverty. The SIGN implant not only repairs broken limbs but also restores broken families. As a SIGN volunteer for almost two decades, I've talked to surgeons from around the world attending the annual SIGN conference. The surgeons from African called SIGN a miracle as they struggle to provide the best care to their patients. SIGN surgery can be performed without power or real time X-rays. For example, surgeons in countries struck by earthquakes and tsunamis are trained to respond to these disasters. SIGN also has the largest orthopaedic database in the world documenting SIGN surgeries and sharing knowledge and information. SIGN employees at the headquarters in Richland, Washington are dedicated and deeply care about each person who is healed by a SIGN implant and a SIGN-trained surgeon. I am humbled and grateful to be part of the SIGN Fracture Care International family.

SIGN Fracture care goes above and beyond to treat the injured poor equally around the world. Every penny is well spent and accounted for. I feel honoured to support such a wonderful organization that sees no boundaries. Truly a humanitarian organization that gives from the heart.

SIGN is changing Somali lives. We got our set in 2019 and since then we helped more than 120 patients. Before that people use to get plated and lie at bed few months. Now they walk next day or as early as they could. People say "Horaa loo kacayaa" which means standing early ...

SIGN Fracture Care is dedicated to filling the need for treatment of fractures in developing countries. The model of education plus donation of appropriate implants for the poor in developing countries has provided care of fractures equivalent to those treated in developing countries. More than 321,000 patients from these countries have received SIGN surgery. More than 350 hospitals are using SIGN Implants and educations. Every week we receive 2 to 5 requests to start new SIGN Programs. Each surgery is reported on the SIGN surgical database which provides evaluation of the current SIGN implants and suggestions for innovations. The database is an area for discussion of surgery between developing country surgeons and United States surgeons.

SIGN Fracture Care has been building orthopaedic capacity in developing countries since 1999. More than 320,000 patients have avoided disability because SIGN has trained and equipped surgeons in these countries to perform limb saving surgery for broken legs and arms. Without their help of donating orthopaedic training and the instruments and implants needed for these surgeries, many patients limbs would not heal, causing disability to the patient and furthering burdening already very poor families.

The dedication of the SIGN Surgeons, Board, Donors, and Employees is what life is all about. So many lives are better because of SIGN.

SIGN Fracture Care has changed the world in developing countries with the donation of their simple yet effective orthopedic implants and instruments. It has given hope to so many when they needed it most.

Making an impact one surgery at a time, SIGN Fracture Care is a testament to what it means to truly create equality of orthopaedic care around the world. The dedication of the SIGN Surgeons, Board, Donors, and Employees is unparalled. When I make a dontation to SIGN, I know I have used my money wisely and my heart feels warm.

I am always humbled and amazed at the kindness, hard work, and dedication toward the betterment of lives for those who are invisible, the unseen. SIGN Fracture Care International knows no boundaries, has no prejudice. Their staff, the Doctors, board members have compassion and a desire to make a difference, a difference in peoples lives.

We just moved to the Tri-Cities five years ago and heard about SIGN through our church. Our first experience was being told about the mission of SIGN and reaching the entire world in terms of correcting orthopaedic deformities. We were going to Malawi, and we volunteered to carry equipment to a SIGN Program there.

It was an amazing experience because we took the nails, met the physician, and he showed us what he had done and how he had changed his patient's life by enabling him to walk again. They don't have as much ability for follow up in rural areas, and this got us interested.

We're volunteering at the 2019 SIGN Conference and getting the chance to meet some of the SIGN Surgeons.

It's the 20th anniversary, and I was recently reminded that I was here for the first board meeting in 1999. Over the 20 years, we have sought to identify and meet the needs then addressed it step-wise by learning from surgeons around the world what their needs are on the ground. Then, we evolve to meet those.

I started in Orthopaedics when I was an intern doctor. In my country, there were only two orthopaedic surgeons for a population of 12 miillion people. There were so many people with fractures that those two doctors were overwhelmed. One day, I came across a young lady who had a femur fracture. When my teacher treated her and she began walking the following day, I saw the magic of orthopaedics. She was treated using the SIGN Nail.

Another man was blind and broke his leg. Dr. Zirkle was in South Sudan and helped us treat that patient, and he was taken home walking with crutches. Those are the cases that impress me and give me the courage to become a SIGN Surgeon. SIGN also helps to train me by sending me to Tanzania for training in orthopaedics and trauma. I've spent the last two years treating 6 - 8 patients per week using the SIGN Program.

Because of SIGN fracture care we are able to help thousands of patients in our country and give quality care inspite of financial constraints.our heart felt gratitude from Ethiopia.

Excellent non-profit that benefits the local community and numerous places around the world it reaches. The annual conference is a wonderful opportunity for global SIGN surgeons to share and learn from each other to further the outreach to benefit more and more patients.

I came to know about SIGN during my residency training but i became really engaged in it when I was assigned as the coordinator during my 2nd year in residency. The most memorable thing for me is how we managed to increase our follow up rate and maintain in to a good level which helped us reach to more patients in need of implant surgery. Hence, i felt with our partnership with SIGN, we eventually became a family. Never yielding to hardships and just continuously serving for the sake of our patients and the families depending on them. This passion from the SIGN network has created a culture of true service in all of us.

SIGN is an amazing organization that supplies orthopedic supplies and education free of charge to under funded hospitals around the globe in order to improve the lives of people who otherwise could not afford medical attention. The people who work for SIGN are inspirational in their complete dedication to their mission. Over the years I have watched the SIGN team work tirelessly recruiting and training new surgeons across the globe, developing more types of implants to better serve their patients, and expanding their reach to more developing counties all the while providing the equipment and services at no cost to the patients. This is an organization that epitomizes humanitarian work.

We are using SIGN Nail to our patients free of cost. Annually about hundreds of our patients get benefited. My sincere thanks to SIGN fracture care international.
Regards
Dr Gajendra Mani Shah
Orthopedic surgeon
Patan Academy of Health Sciences
Nepal

Without SIGN our poor Patients here in Ethiopia would have been disabeled and bed ridden.

I have been working with SIGN to develop their quality system for the last 10 years. As a medical device manufacturer, there are many requirements that must be met to ensure safe and effective products. SIGN works tirelessly to adhere to these regulations and standards, and does so while always keeping their patients as the top priority. It is truly inspiring to be a part of their world-class organization. I continue to learn from their commitment to their mission and the best in class systems they have in place.

I first met Dr. Lew Zirkle in the early 1980s. We had both served in a medical capacity in the Vietnam war and had both done teaching of orthopaedic surgery in developing countries through Orthopaedics Overseas. Lew had observed that we were unable to do much effective treatment of fracture patients because of a lack of bone implants (nails, plates, screws). In the mid 90's he began to conceive of SIGN. I saw him as a man of vision and action but did not dream that he would bring to life an organization which would change the face of Third World orthopaedic and trauma care. I have proudly served on the SIGN Board since 2002 and each year I marvel at the growth and effectiveness of SIGN under his leadership. Putting in over 70 hours of SIGN work weekly, Lew has never taken a salary. A SIGN donor can be assured that every dollar donated is efficiently treating the poor of the world.
David S. Whitney, MD

SIGN is a wonderful organization with an incredible mission to improve lives in countries facing significant challenges.

We have been a sponsor of SIGN Fracture Care International for several years and are very proud of our involvement with this nonprofit. Dr. Zirkle and his team of dedicated employees have literally saved the livelihoods of tens of thousands of people worldwide, This group operates with the highest integrity and we hold them in the greatest esteem. SIGN's CEO, Jeanne Dillner, is truly dedicated and inspirational. Dr. Lew Zirkle's innovative implants have allowed patients in third world countries to avoid severe disabilities. We commend this wonderful organization for their commitment to service.

I have been supporting SIGN Fracture Care International through Kiwanis since 2003. The WHO lists trauma as the worst problem in the developing world and to my knowledge SIGN is the only organization that is addressing it. They have developed implants and the instruments to use them and manufacture them in Richland WA. They furnish the implants, instruments and training free as long as the patient recieves the surgery free. They now support over 300 hospitals in 50 countries, performed over 300,000 surgeries and trained over 5000 surgeons. This year they will ship over 30,000 implants. I visited a SIGN hospital in Tanzania in 2011 and got to meet the grateful surgeons and patients. There is no better bang for the buck!

SIGN Fracture Care International is a fabulous non-profit organization helping individuals and families around the world by healing fractures that would otherwise go untreated. The development of the procedure and nails by Dr. Zirkle and his team has touched and improved lives in countries where care is often challenged or non-existent. The Pacific Northwest District of Kiwanis International is honored to have SIGN as one of our district projects. The work SIGN does is valuable and it is improving the lives of children and families around the globe.

I have worked with SIGN for nearly 5 years now as a member of their Board of Directors and as legal counsel. I can say without reservation working with SIGN is one of the most important things in my professional life. But perhaps even more important is that my personal life has been enriched and forever changed because of the people who dedicate their lives' work to SIGN. Day in and day out, the folks at SIGN strive to bring care and compassion to people all over the world who would otherwise have none. I had no idea that traffic accidents in third world countries were such a source of tragedy. The accident itself is, of course, terrible. But what happens to people's lives and families after such an accident (if care is not available) is absolutely horrific. SIGN has had a single mission since its inception: to provide life saving care and to protect and preserve these individual's way of life by restoring their ability to provide for their families. It is so much more than just providing surgery and medical care; it truly is about saving the lives of everyone affected by such an accident. What impresses me the most about Dr. Zirkle's vision is that he is truly "teaching a man to fish". By establishing teaching centers and hospitals where the SIGN nail and related products are used by local surgeons, SIGN is ensuring that the desperately needed care will always be there. SIGN is teaching surgeons in countries around the world how to use the SIGN nail and how to achieve the very best results. THAT is the aspect of SIGN's mission that is working to save lives now AND into the future. The vision of one great man and the commitment and selflessness of so many others makes SIGN what it has become today. A true beacon of light for thousands who would otherwise be plunged into darkness. I am beyond humbled to be included among the ranks of those whose lives SIGN has touched.

No other health care not for profit can match SIGN's commitment and ability to deliver patient care resources coupled with education and support for a developing nation's Orthopaedic trauma community. I am proud to call myself a supporter of this mission driven organization

We gladly support and donate the majority or our charitable contributions to SIGN every year. What distinguishes SIGN for us is how they support the local doctors with the equipment and training they request so they can treat their own patients. SIGN is helping hospitals built local trauma care capacity to break the cycle of poverty and reduce long term disability for patients affected by conflicts, disasters, and road traffic accidents. We share SIGN's mission for equality of care and peace for those with few options.

Antje & Joel Gillard