Civic Intelligence

Sign Fracture Care International

EIN 91-1952283 • 501(c)3 • Richland, WA

Profile

Sign partners with overseas surgeons to build sustainable orthopaedic capacity by donating education, instruments, and implants. By working with teaching hospitals and hosting educational conferences worldwide, sign equips surgeons to heal patients within their own communities.

451 Hills Street Suite BRichland, WA 99354

www.signfracturecare.org

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

23rd percentile

0.03x

Higher debt load relative to assets than 23% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Source year 2024

Liabilities / Revenue

22nd percentile

0.06x

Higher debt load relative to revenue than 22% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Source year 2024

Net Margin

53rd percentile

5.4%

Higher net margin than 53% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Source year 2024

Top Officer Pay

55th percentile

$198,980

Higher top officer pay than 55% of similar nonprofits.

Top officer pay equals 2.8% of source-year revenue.

501(c)3 • $10M-$25M nonprofits • Source year 2024

Asset Growth

49th percentile

4.1%

Faster asset growth than 49% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Annualized from 2023 to 2024

Revenue Growth

61st percentile

13%

Faster revenue growth than 61% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Annualized from 2023 to 2024

Assets

Up

$15,598,095

Up $617,487 (+4.1%) from 2023

Liabilities

Down

$407,801

Down $59,562 (-13%) from 2023

Net Assets

Up

$15,190,294

Up $677,049 (+4.7%) from 2023

Revenue

Up

$7,005,562

Up $800,351 (+13%) from 2023

Expenses

Down

$6,624,843

Down $622,117 (-8.6%) from 2023

Net Income

Up

$380,719

Up $1,422,468 (+137%) from 2023

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$20M$15M$10M$5.0M$0Assets 2010: $5,910,423Liabilities 2010: $502,361Net Assets 2010: $5,408,0622010Assets 2011: $5,760,536Liabilities 2011: $339,677Net Assets 2011: $5,420,8592011Assets 2012: $5,844,377Liabilities 2012: $211,744Net Assets 2012: $5,632,6332012Assets 2013: $6,555,273Liabilities 2013: $296,681Net Assets 2013: $6,258,5922013Assets 2014: $10,692,929Liabilities 2014: $234,764Net Assets 2014: $10,458,1652014Assets 2015: $11,248,740Liabilities 2015: $223,976Net Assets 2015: $11,024,7642015Assets 2016: $12,275,026Liabilities 2016: $220,266Net Assets 2016: $12,054,7602016Assets 2017: $11,692,188Liabilities 2017: $238,375Net Assets 2017: $11,453,8132017Assets 2018: $9,652,006Liabilities 2018: $283,605Net Assets 2018: $9,368,4012018Assets 2019: $11,949,446Liabilities 2019: $324,872Net Assets 2019: $11,624,5742019Assets 2020: $12,430,004Liabilities 2020: $408,406Net Assets 2020: $12,021,5982020Assets 2021: $16,004,301Liabilities 2021: $347,896Net Assets 2021: $15,656,4052021Assets 2022: $15,343,472Liabilities 2022: $383,197Net Assets 2022: $14,960,2752022Assets 2023: $14,980,608Liabilities 2023: $467,363Net Assets 2023: $14,513,2452023Assets 2024: $15,598,095Liabilities 2024: $407,801Net Assets 2024: $15,190,2942024

Highlighted filing

2024

Assets$15,598,095
Liabilities$407,801
Net Assets$15,190,294

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$15M$10M$5.0M$0-$5.0MRevenue 2010: $7,350,149Expenses 2010: $6,205,670Net Income 2010: $1,144,4792010Revenue 2011: $4,035,810Expenses 2011: $3,989,489Net Income 2011: $46,3212011Revenue 2012: $4,344,193Expenses 2012: $4,210,262Net Income 2012: $133,9312012Revenue 2013: $5,421,378Expenses 2013: $5,029,912Net Income 2013: $391,4662013Revenue 2014: $8,978,886Expenses 2014: $4,808,887Net Income 2014: $4,169,9992014Revenue 2015: $13,320,994Expenses 2015: $12,462,315Net Income 2015: $858,6792015Revenue 2016: $5,521,131Expenses 2016: $4,788,660Net Income 2016: $732,4712016Revenue 2017: $4,712,963Expenses 2017: $5,661,218Net Income 2017: -$948,2552017Revenue 2018: $4,971,197Expenses 2018: $6,333,965Net Income 2018: -$1,362,7682018Revenue 2019: $9,580,060Expenses 2019: $7,773,865Net Income 2019: $1,806,1952019Revenue 2020: $6,412,435Expenses 2020: $6,709,456Net Income 2020: -$297,0212020Revenue 2021: $9,574,636Expenses 2021: $6,263,450Net Income 2021: $3,311,1862021Revenue 2022: $7,573,337Expenses 2022: $7,157,471Net Income 2022: $415,8662022Revenue 2023: $6,205,211Expenses 2023: $7,246,960Net Income 2023: -$1,041,7492023Revenue 2024: $7,005,562Expenses 2024: $6,624,843Net Income 2024: $380,7192024

Highlighted filing

2024

Revenue$7,005,562
Expenses$6,624,843
Net Income$380,719

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$15.6$0.41$15.2$7.01$6.62$0.38
2023Summary only. Only limited summary data is available for this year.$15.0$0.47$14.5$6.21$7.25$1.04
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$15.3$0.38$15.0$7.57$7.16$0.42
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$16.0$0.35$15.7$9.57$6.26$3.31
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$12.4$0.41$12.0$6.41$6.71$0.30
2019Facts available. Structured filing facts are available, but richer extracted sections are limited.$11.9$0.32$11.6$9.58$7.77$1.81
2018Summary only. Only limited summary data is available for this year.$9.65$0.28$9.37$4.97$6.33$1.36
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$11.7$0.24$11.5$4.71$5.66$0.95
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$12.3$0.22$12.1$5.52$4.79$0.73
2015Summary only. Only limited summary data is available for this year.$11.2$0.22$11.0$13.3$12.5$0.86
2014Detailed filing. Detailed filing data is available for this year.$10.7$0.23$10.5$8.98$4.81$4.17
2013Detailed filing. Detailed filing data is available for this year.$6.56$0.30$6.26$5.42$5.03$0.39
2012Summary only. Only limited summary data is available for this year.$5.84$0.21$5.63$4.34$4.21$0.13
2011Summary only. Only limited summary data is available for this year.$5.76$0.34$5.42$4.04$3.99$0.05
2010Summary only. Only limited summary data is available for this year.$5.91$0.50$5.41$7.35$6.21$1.14
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2024 to Dec 31, 2024
Signed
Jul 24, 2025
Return Version
2024v5.2
Gross Receipts
$8,082,596
Mission and Program Overview

Mission

Sign partners with overseas surgeons to build sustainable orthopaedic capacity by donating education, instruments, and implants. By working with teaching hospitals and hosting educational conferences worldwide, sign equips surgeons to heal patients within their own communities.

Give patients access to affordable and effective orthopaedic care in lmic.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$5,066,619$5,531,828▲ $465,209
Land, Buildings, and Equipment, Net$4,947,637$4,971,812▲ $24,175
Savings and Temporary Cash Investments$2,403,653$1,987,581▼ $416,072
Cash and Non-Interest-Bearing Accounts$1,121,718$1,813,294▲ $691,576
Inventories for Sale or Use$1,200,185$1,036,574▼ $163,611
Prepaid Expenses and Deferred Charges$162,094$137,011▼ $25,083
Accounts Receivable$66,958$110,680▲ $43,722
Intangible Assets$11,744$9,315▼ $2,429
Total Assets$14,980,608$15,598,095▲ $617,487
Liabilities
Accounts Payable and Accrued Expenses$467,363$407,801▼ $59,562
Total Liabilities$467,363$407,801▼ $59,562
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$13,499,738$14,326,232▲ $826,494
Net Assets With Donor Restrictions$1,013,507$864,062▼ $149,445
Total Net Assets Fund Balance$14,513,245$15,190,294▲ $677,049
Total Liabilities and Net Assets / Fund Balance$14,980,608$15,598,095▲ $617,487

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$1,231,936$2,029,392$3,261,328
Leasehold Improvements$1,150,626$893,712$2,044,338
Buildings$1,259,180$372,208$1,631,388
Other Land Buildings$450,070$480,039$930,109
Land$880,000-$880,000
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Jeanne DillnerSecretary/treasurer/CEOFT$182,707$16,273$198,980
Terry SmithEngineering ManagerFT$161,840$6,738$168,578
Robert SchmittRegulatory Affairs ManagerFT$138,208$14,493$152,701
Brian BarnesIt ManagerFT$128,507$13,856$142,363
Franklyn FaultersackQuality Assurance ManagerFT$110,779$30,928$141,707
Joel GillardSenior R&d EngineerFT$116,464$15,418$131,882

Board Members and Trustees

NameTitle
Lewis G Zirkle MdPresident/founder
David Shearer MdVice President
Ann PennerBoard Member
Ben RiveraBoard Member
Carla Smith Md PhdBoard Member
Daniele Sciuto MdBoard Member
Michael Coscia MdBoard Member
Patrick Yoon MdBoard Member
Randall HuebnerBoard Member
Richard Gellman MdBoard Member
Stephen SchwartzBoard Member
Revenue and Support

Revenue Composition

Contributions and Grants
$6,175,920
Program Service Revenue
$440,249
Investment Income
$345,163
Other Revenue
$44,230
All Other Contributions
$6,090,930
Change in Net Assets
$380,719

Noncash Contribution Practices

Property subject to holding requirements
No
Reviewed unusual noncash gifts
No
Third parties used for noncash contributions
No

Noncash Contributions

Contribution TypeContribution CountReported AmountValuation Method
Drugs and Medical Supplies30$350,914Fair Value
Securities Publicly Traded5$80,670Fair Value
Other Non Cash Contri Table6$27,215Fair Value
Other Non Cash Contri Table5$18,361Fair Value
Other Non Cash Contri Table19$16,697Fair Value
Food Inventory1$3,300Fair Value
Books and Publications-$880Fair Value
Clothing and Household Goods-$720Fair Value
Total Noncash Contributions66$498,757-

Audited Revenue Reconciliation

Revenue per Audited Statements
$7,005,562
Revenue Not Reported on Financial Statements
$0
Revenue Not Reported on Form 990
$2,623,206
Total Revenue per Audited Statements
$9,628,768
Total Revenue per Form 990
$7,005,562
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$3,654,989
Salaries, Compensation, and Employee Benefits$2,780,029
Total Fundraising Expense$617,545
Grants and Similar Amounts Paid$189,825
Professional Fundraising Fees$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$1,958,215$224,138$412,986$2,595,339
Depreciation Depletion$204,355$15,012$28,118$247,485
Foreign Grants$189,825--$189,825
Current Officers, Directors, Trustees, and Key Employees$148,232$13,852$22,606$184,690
Conferences and Meetings$178,391--$178,391
All Other Expenses$114,067$18,617$19,133$151,817
Fees for Services Other$47,539$30,513$42,396$120,448
Other Expenses$30,838$19,668$23,797$74,303
Travel$48,083$1,521$1,564$51,168
Fees for Service Investment Mgmnt Fees-$24,567-$24,567
Insurance$14,108$1,600$2,933$18,641
Occupancy$7,728$196$359$8,283
Total Functional Expenses$5,644,852$362,446$617,545$6,624,843

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Audited Statements$8,951,719
Expenses per Audited Statements$6,624,843
Total Expenses per Form 990$6,624,843
Expenses Not Reported on Form 990$2,326,876
Expenses Not Reported on Financial Statements$0
International Activity

International Summary

Offices
0
Employees
0
Spending
$6,005,702

International Compliance

Foreign grant records maintained
No
Activity in boycott countries
No
Foreign corporation ownership
No
Foreign partnership interest
No
Interest in foreign trust
No
Passive foreign investment company interest
No
Transfers to foreign corporations
No

International Activities

RegionActivityServicesOfficesEmployeesSpending
Sub-saharan AfricaProgram ServicesOrthopaedic Implants00$3,968,565
South AsiaProgram ServicesOrthopaedic Implants00$1,402,506
East Asia and the PacificProgram ServicesOrthopaedic Implants00$300,295
Sub-saharan AfricaGrantsTraining, Implants, Stipend00$187,466
Central America and the CaribbeanProgram ServicesOrthopaedic Implants00$90,035
Middle East and North AfricaProgram ServicesOrthopaedic Implants00$29,740
South AmericaProgram ServicesOrthopaedic Implants00$27,095
Fundraising, Events, and Gaming
Fundraising activities
Yes
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$17,608
Fundraising Gross Income$12,916
Professional Fundraising Fees$0

Fundraising Events

EventGross ReceiptsGross RevenueDirect ExpensesNet Income
Tri-city Benefit$97,906$12,916$4,692$8,224
Total Events$97,906$12,916$17,608$-4,692
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, Line 11B

A draft of form 990 is provided to sign's ceo. The form 990 is presented for review to the board of directors. Any changes are then directed to the return preparer and addressed before the final return is filed.

Form 990, Part VI, Section B, Line 12C

The conflict of interest policy is monitored and reviewed by the chief compliance officer. The chief compliance officer requests annual conflict of interest statements from each board member. The statements are reviewed with the ceo/secretary and dispositioned. The president is briefed on findings along with the full board.

Form 990, Part VI, Section B, Line 15

An annual performance review is conducted for all employees including the ceo. The entity's size, industry, type of organization, and position of responsibilities are considered in determining compensation adjustments. According to the organization's by-laws, the president is authorized to conduct the ceo's annual review and determine compensation. The organization utilizes a subscription to payscale which provides accurate salary information to establish pay ranges for employees. Payscale also allows the organization to input performance ranking data in order to obtain "recommended raises" via those ranks juxtaposed with where each individual's current salary lands in the salary range for their position.

Form 990, Part VI, Section C, Line 19

The public may contact the organization at it's physical location to request copies of its governing documents, conflicts of interest policy, and financial statements.

Filing and Contact Details

Filer

Filer Name
Sign Fracture Care International
EIN
91-1952283
Phone
5093711107
Address
451 HILLS STREET SUITE B, RICHLAND, WA 99354
Doing Business As
Sign

Signing Officer

Name
Jeanne Dillner
Title
Chief Executive Officer
Phone
5093711107
Signed
2025-07-24
Discuss with paid preparer
Yes

Organization Details

Formed
1999
Legal Domicile
Wa
Voting Board Members
11
Independent Board Members
11
Employees
43
Volunteers
53

Preparer

Firm
Northwest CPA Group Pllc
Address
1333 COLUMBIA PARK TRAIL STE 120, RICHLAND, WA 99352
Preparer
Alison C Gebers
Phone
5097351300
Supplemental Narrative

Additional Explanations

FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:

Sign's vison is to create equality of fracture care throughout the world. In implementing its vision, sign empowers surgeons, implants hope and restores the lives of the injured poor around the world. Sign surgery enables people with severely broken bones to walk and return home within one week of surgery and return to normal function within a few weeks. Sign's mission is to give the injured poor access to fracture surgery by donating orthopaedic education and implant systems to surgeons in developing countries. Sign builds sustainable orthopaedic capacity in low- and middle-income countries (lmic) by educating local surgeons to care for and treat patients in their home communities. Sign equips the surgeons with the skills and tools they need, enabling them to provide ongoing care and support to their patients. This education is augmented through the provision of a sustainable supply of orthopaedic implants and instruments designed for use in low-resource hospital conditions. By empowering surgeons in lmic, these surgeons are able to achieve equitable results in the treatment they provide to patients in their communities. Sign designs and manufactures the sign im nail system which is designed for use in austere operating room conditions. Sign fracture care international is registered with the united states food and drug administration (fda). Sign manufactures finished medical devices in compliance with the code of federal regulations, fda quality system regulation. Sign maintains a quality management system that is certified to be compliant with iso 13485:2016. Additionally, sign distributes in-kind donations of products not manufactured by sign to some of the busier programs. According to the world health organization (who), the epidemic of injuries caused by road traffic accidents, work injuries, and conflicts affects 20 to 50 million people every year. Ninety percent of the people injured live in lmic where access to adequate care is limited. By equipping local surgeons with the skills and tools they need, sign enables them to provide ongoing care and support to their patients. This empowerment uplifts recipients and their families, enabling them to break free from the cycle of poverty. There are approximately 7,000 surgeons in more than 410 hospitals in 57 lmic which have benefited from sign education and the provision of implants and instruments. With more than 400,000 surgeries to date, and with an average family size of five, this means sign has touched and improved the lives of over 2 million people. Sign also responds to disasters and conflicts in locations where sign has existing programs or where sign programs need to be developed. Since electricity and other resources typically found in operating rooms aren't needed to perform sign surgery, it is an effective means to reduce the number of permanent disabilities for injured people following a natural disaster or conflict.

Form 990, Part XII, Line 2C

The organization has not changed their oversight process or selection process of selecting an independent auditor during the tax year.

Financial Statement Notes

PART X, LINE 2:

Management has evaluated the organization's tax positions and concluded that the organization has taken no uncertain tax positions that require adjustments to the financial statements.

PART XI, LINE 2D - OTHER ADJUSTMENTS:

Rental expenses 17,678. Special event expenses 17,608. Loss on disposal of equipment 11,608.

PART XII, LINE 2D - OTHER ADJUSTMENTS:

Rental expenses 17,678. Loss on disposal of equipment 11,608. Special event expenses 17,608.

Raw XML AppendixShowing 400 of 803 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/ActivitiesConductedPrtshpInd00
IRS990/ActivityOrMissionDesc0GIVE PATIENTS ACCESS TO AFFORDABLE AND EFFECTIVE ORTHOPAEDIC CARE IN LMIC.
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IRS990/Desc0NEARLY 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. IN 2024, THE ELBOW PLATE BENDING TEMPLATE WAS RELEASED. THE ELBOW PLATE BENDING TEMPLATE IS USED TO CONTOUR SMALL BONE FRAGMENTARY PLATES, SUCH AS THE SIGN FX PLATES, TO MATCH THE ANATOMY OF THE DISTAL HUMERUS AND OLECRANON WHEN STABILIZING ELBOW FRACTURES. THE TEMPLATE CAN BE USED WITH NON-SIGN PRODUCTS (LIKE THE 3.5MM RECONSTRUCTION PLATES) AND BOTH BEFORE AND DURING SURGERY.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 2024, WE DISTRIBUTED 27,107 SIGN NAILS TO 48 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 2024. THE BREAKDOWN WAS AS FOLLOWS: AFRICA: 15 PROGRAMS ASIA: 6 PROGRAMS NORTH AMERICA: 1 (HAITI)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. WE STARTED SIGN SPINE PROGRAMS IN KENYA AND TANZANIA IN 2024 AND ARE PROJECTED TO START FIVE ADDITIONAL SIGN SPINE PROGRAMS IN THE COMING YEAR. AS OF DECEMBER 31, 2024, THE WORLD BANK INCOME CLASSIFICATIONS BY GNI FOR THE COUNTRIES WITH NEW SIGN PROGRAMS WERE AS FOLLOWS: LOW INCOME: 48% LOWER MIDDLE INCOME: 44% UPPER MIDDLE INCOME: 8%DISASTER AND CONFLICT RESPONSE:WE BELIEVE IN EQUALITY OF FRACTURE CARE FOR ALL, REGARDLESS OF GENDER, RELIGION, POLITICAL AFFILIATION, OR ANY OTHER IDENTITY. WE CONTINUE TO SUPPORT THE 17 SIGN PROGRAMS IN HAITI AS BEST AS WE ARE ABLE. THE ONGOING GANG VIOLENCE IN THE COUNTRY LIMITS OUR ABILITY TO PROVIDE REPLACEMENT SIGN IMPLANTS AND INSTRUMENTS AS AIRLINES ROUTINELY CANCEL FLIGHTS. WE CONTINUE TO COMMUNICATE WITH THE SURGEONS IN-COUNTRY AND SEND REPLACEMENT SIGN IMPLANTS AND INSTRUMENTS THROUGH AVAILABLE AVENUES AS THEY APPEAR.IN LATE 2024, A STUDENT-LED MOVEMENT OUSTED THE CURRENT PRIME MINISTER OF BANGLADESH. THE FALLOUT OF THE MOVEMENT RESULTED IN AN INCREASE IN VIOLENCE FROM VARIOUS INTERNAL GROUPS. A LOCAL SIGN SURGEON ALERTED US TO THE INCREASE IN FRACTURE PATIENTS IN THE WEEKS FOLLOWING THE OUSTING OF THE FORMER PRIME MINISTER AND REQUESTED ADDITIONAL SIGN NAILS AND INSTRUMENT SETS TO TREAT THE INFLUX OF PATIENTS. IN RESPONSE TO THEIR REQUEST, WE PROVIDE TWO ADDITIONAL SIGN SETS AND 130 SIGN NAILS TO ASSIST WITH THE INCREASED PATIENT LOAD.IN MYANMAR, THE EFFECTS OF THE MILITARY COUP ARE STILL FELT BY THE POOR POPULATION, AND ACCESS TO F
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IRS990/MissionDesc0SIGN PARTNERS WITH OVERSEAS SURGEONS TO BUILD SUSTAINABLE ORTHOPAEDIC CAPACITY BY DONATING EDUCATION, INSTRUMENTS, AND IMPLANTS. BY WORKING WITH TEACHING HOSPITALS AND HOSTING EDUCATIONAL CONFERENCES WORLDWIDE, SIGN EQUIPS SURGEONS TO HEAL PATIENTS WITHIN THEIR OWN COMMUNITIES.
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IRS990/ProgSrvcAccomActy2Grp/Desc0WE 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 2024 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 SPECIAL FULL-DAY SESSION ON THORACIC SPINE.THE 2024 SIGN CONFERENCE FEATURED 62 SURGEONS FROM 26 COUNTRIES AND INCLUDED TWO NEW SESSIONS: A FIRST TIME ATTENDEE ORIENTATION AND A PILOT BIOSKILLS LAB ON HEMIARTHROPLASTY. THE FIRST TIME ATTENDEE ORIENTATION WAS ATTENDED BY 11 SURGEONS AND INCLUDED A TOUR OF SIGN HQ AND BREAKOUT SESSIONS TO FAMILIARIZE NEW ATTENDEES WITH OUR INSTRUMENTS AND IMPLANTS.THE BIOSKILLS LAB AND PROCEDURAL LEARNING CENTER, WHICH WAS COMPLETED IN EARLY 2022, CONTINUES TO BE A FOCAL POINT DURING THE SIGN CONFERENCE. THESE FACILITIES ALLOW CONFERENCE ATTENDEES TO EXPERIENCE HANDS-ON TRAINING FROM EXPERT CLINICAL EDUCATORS. THE LAB SESSIONS TEACH CRITICAL TECHNIQUES SUCH AS PELVIC FRACTURES/HEMIARTHROPLASTY, PROXIMAL FEMUR FRACTURES, ELBOW FRACTURES, ANKLE FRACTURES/FUSIONS, THORACIC SPINE, AND TIBIAL PLATEAU FRACTURES. WE CONTINUE TO DEVELOP OUR RELATIONSHIP WITH THE INSTITUTE FOR GLOBAL ORTHOPAEDICS AND TRAUMATOLOGY (IGOT). IN 2024, IGOT HOSTED THEIR THREE-DAY SURGICAL MANAGEMENT AND RECONSTRUCTIVE TRAINING COURSE (SMART) COURSE AT SIGN HEADQUARTERS AFTER THE CONCLUSION OF THE SIGN CONFERENCE. THIS ALLOWED NEARLY ALL CONFERENCE ATTENDEES TO ATTEND AND RECEIVE ADDITIONAL CADAVER TRAINING IN FLAPS FOR SOFT TISSUE RECONSTRUCTION AND DEFORMITY CORRECTION. THE SMART COURSE INCLUDED A "REAL-LIFE" SURGICAL CASE SIMULATION, PROVIDING ATTENDEES WITH THE OPPORTUNITY TO APPLY THE SKILLS THEY LEARNED OVER THE WEEK INTO PRACTICE. IGOT ALSO HELD A CLINICAL RESEARCH SYMPOSIUM FOCUSED ON CONDUCTING STUDIES TO ADDRESS CRITICAL TREATMENT QUESTIONS FACED BY THE ATTENDEES' SPECIFIC PATIENT POPULATIONS.IGOT ALSO PROVIDES REGIONAL TRAINING IN OTHER SURGICAL TECHNIQUES TO SIGN SURGEONS IN EAST AFRICA AND NEPAL.THE 1ST INTERNATIONAL SIGN CONFERENCE WAS HELD AT SHAHAB ORTHOPAEDIC HOSPITAL IN PESHAWAR, PAKISTAN IN APRIL 2024. MORE THAN 60 AFGHANI AND PAKISTANI SURGEONS ATTENDED AND DOZENS MORE PARTICIPATED VIA TELECONFERENCE. MODELING THE FORMAT AFTER THE ANNUAL SIGN CONF
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IRS990/ProgSrvcAccomActy3Grp/Desc0PEOPLE LIVING IN LMIC CANNOT ACCESS SPINE CARE WHEN IT IS NOT AVAILABLE IN THEIR COMMUNITY. THE INCIDENCE OF TRAUMATIC SPINAL INJURIES IN LMIC 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.
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