Sign Fracture Care International

Nearly half of the world lives on less than $8.30 per day. Patients are too poor to buy the implants needed, and most hospitals do not have the resources to purchase the implants. When a person living in a low- or middle-income country (lmic) breaks an arm or leg and cannot afford appropriate care, it can easily send their whole family spiraling into poverty. We developed an innovative implant system for treating patients in low-resource hospitals. This system can be used without expensive x-ray imaging or electricity. Sign surgery typically enables a patient with a fractured bone to walk in 1 day, leave the hospital in 1 week, and be back at work in 1 month. The patient avoids possible permanent disability and is returned to mobility. See schedule o on how we distribute appropriate orthopaedic technology.distribute appropriate orthopaedic technology:the sign im nail and interlocking screw system is designed for use in hospitals in developing countries where c-arms and reliable power are not available. Sign engineers continually develop new orthopaedic instruments and implants in response to the needs described by the local surgeons. We supply new sign programs with the sign im nail system, which surgeons use to repair severe fractures in the femur, tibia, and humerus. Once a program has demonstrated its ability to report their cases, including adequate follow-up that confirms their results comply with our expectations, they become eligible to receive additional sign products, as well as in-kind donations received from for-profit orthopaedic implant companies.in 2025, we distributed 28,356 sign nails to 52 countries. Our aim is to enable the poor to gain access to affordable orthopaedic surgery, which means the majority of our implants are donated free of charge to the patient.we started 22 new sign programs in 2025. The breakdown was as follows: africa: 16 programs asia: 6 programs as of december 31, 2025, the world bank income classifications by gni for the countr

We build sustainable orthopaedic capacity in lmic by educating local surgeons to care for patients in their home communities. For 26 years, sign has been working alongside surgeons in lmic, raising orthopaedic knowledge and skill. We now rely on sign surgeon mentors to provide education to new surgeons. Once new surgeons are trained, they receive their own starter set of the sign im nail system with training materials included. The training manuals are augmented by online mentorship via the sign surgical database (ssdb). Surgeons are required to enter cases into the ssdb in exchange for a free resupply of sign nails. Each case is reviewed by an orthopaedic surgeon from our board or experienced sign surgeon mentors. Their feedback on each case is sent to all orthopaedic surgeons at that hospital via email.we provide access to orthopaedic training and education to surgeons in developing countries via five primary channels:1. Onsite visits by local surgeons and north american and european surgeons. 2. Email communications with sign headquarters.3. Discussion topics and educational resources posted on our website, the hub.4. Review of cases submitted to the sign surgical database by senior orthopaedic surgeons and sign board members. 5. Regional sign and trauma conferences, as well as the annual international orthopaedic conference held at sign headquarters.the objectives for all modes of training are: 1) ensure sign surgeons understand the surgical technique for the sign products in their hospital; 2) provide training on current and relevant orthopaedic principles; and 3) provide training in orthopaedic and trauma procedures for injuries such as open wounds, limb deformity, pediatric, and pelvic.expand training and educational opportunities:the annual sign conference was held in september 2025 at sign headquarters in richland, washington. This conference provided a combination of didactic lectures on fracture management, case studies, seven cadaver lab sessions, and a

People living in lmics cannot access spine care when it is not available in their community. The incidence of traumatic spinal injuries in lmics is estimated to be 13.7 cases per 100,000 persons. Sign has implemented a sign spine program at two hospitals in two counties. We have plans to expand into three more countries with a total of 10 sites. We have three goals: 1. Improve access to safe spine surgery worldwide. 2. Improve access to spine surgical education and training. 3. Improve access to affordable spine implants. Sign is partnering with teaching hospitals in canada to provide year-long fellowships for surgeons from lmic hospitals. The graduates will return to their hospitals to provide safe, effective care for patients with spine injuries, as well as provide training to other surgeons.we have also begun developing a new kind of program, focused on providing education and implants relating to treating spine fractures. This new program is referred to as sign spine. As of 2025, we have active spine programs in kenya, tanzania, malawi, ethiopia, and pakistan.