SIGN Products

designed specifically for use in developing countries



SIGN ensures that the injured in developing countries are treated with implants that are of the same quality as those used at the hospitals in our hometown.


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We design, manufacture, and distribute orthopaedic instruments and implants from our facility in Richland, Washington.


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.


The SIGN System enables surgeons in low- and middle-income countries to treat long bones fractures with intramedullary nailing. This is the “gold standard” of treating severe bone fractures around the world, and SIGN makes it accessible to hospitals that do not have C-arms (real-time x-ray machines) or reliable electricity in the operating room.

SIGN's Target Arm and Slot Finder work together, enabling a surgeon to locate the distal slot in the nail and insert an interlocking screw with tactile feedback, rather than relying on C-arm imaging.

Treats: severe long bone fractures



The SIGN Nail is an intramedullary nail that is held in place by interlocking screws to stabilize a fractured bone and enable bone healing.

The SIGN Fin Nail does not require interlocking screws at the distal end, which makes surgery simpler and significantly faster. Recent research shows that the Fin Nail is as effective as the standard SIGN Nail in comparable femur fractures.

The SIGN Pediatric Nail uses fins from the Fin Nail and is scaled to better fit in young patients. The interlock bypasses the growth plates and the fins allow the implant to slide inside the bone canal, so it does not inhibit growth.

Treats: fractures of the tibia, femur, and humerus



Some fractures, particularly near the ends of the bone, require additional stabilization. SIGN created FX Plates to enable surgeons to treat these complex injuries. The plates can be bent by the surgeon to follow the unique curvature of each bone. The FX Plates are designed to be anchored to a SIGN Nail, or they can be used independently.

Treats: proximal femur fractures, additional severe fractures



SIGN Nails and Plates are held in place with interlocking screws. These screws are inserted through the slots of the nail to stabilize the fractured bone segments. Screws are manufactured in a range of lengths and diameters to fit the bone and fracture type. Depending on the type of fracture and SIGN Nail used, 1 to 4 screws can be used in each surgery.

Compression screws use thread patterns that are designed to pull fragments of bone together. These screws were originally designed to be used with the SIGN Hip Construct System. They are often used to add additional strength and stability in severe fractures.

Connects implant to bone fragments for stabilization and healing



Feedback from surgeons in developing countries has inspired other products to improve surgery.

The SIGN Hand Reamers and Flute Scraper were designed to collect bone graft material from the patient during surgery, which can be placed back at the fracture site to speed healing.

Improves efficiency and patient outcomes in SIGN Surgery