In October 2000, I toured our several SIGN projects in Vietnam. I was gratified to see the increased number of SIGN cases that are now being done. I established several new projects while I was there. The SIGN site at Cho Ray in Ho Chi Minh City alone has treated at least 80 femur fractures with our nail in the retrograde fashion. (“Retrograde” means that the nails are installed upward through the lower end of the femur rather then down through the top.) Dr. Lam at Cho Ray may very well have performed the largest number of such surgeries in the world.

I was amazed at how well the SIGN patients in Vietnam have done. Remarkably, they have experienced no infections. I met many of the patients in Ho Chi Minh City and Hanoi treated with SIGN nails and found them healthy and thankful. In the Orient, it is important that people be able to squat and all of the SIGN patients I met were able to demonstrate this.

In Hanoi’s medical culture, the older professors must approve innovations before they can be implemented. We were fortunate that all of the key medical leaders in Vietnam have given the necessary approvals. We started in a single hospital and now have projects in five of Vietnam’s larger hospitals and in one province hospital (Haiphong). The eminent Drs. Long and Tuan write frequently and regularly send us case reports, expressing satisfaction at the outcomes of the SIGN surgeries in their hospitals.

I plan to visit Vietnam in June 2001, and while I am there we will have a conference in which many of the SIGN surgeons will make presentations and review one another’s cases. Surgeons from other hospitals who would like to become SIGN surgeons will also attend the conference. In the afternoon we will have a live SIGN operation that everyone present will be able to view on closed-circuit television. We will narrate as the operation progresses so all can understand exactly how the surgery is done and get answers to their questions.

An important part of my role at the conference will be to solicit advice from the Vietnamese surgeons about SIGN’s new products. The enthusiasm of the Vietnamese surgeons is infectious. They are innovative and persistent, and have spread the word about SIGN technology so earnestly that it has become the treatment of choice for tibia and femur fractures throughout Vietnam.

There are already many new products in SIGN’s pipeline, including: (1) nails to fix fractures in other parts of the body, (2) reamers, and (3) devices to help insert nails (so we don’t have to drive them in with mallets, sometimes causing additional fractures).

Mexico would like us to go to Monterey, Guadalajara and Mexico City later in the summer. We are sending to Uganda a shipment of general medical supplies as well as SIGN technology. I also plan to visit Africa in late 2001 or early 2002.

You can see that we at SIGN have been very busy. In addition to our five new projects in Vietnam, we will add still more sites after the conference in June. Each SIGN project needs x-ray capability in the operating room to enable SIGN surgeons to check (1) the reduction of fractures, (2) the positions of nails and interlocking screws before leaving the operating room. (This is important because, in IM nail/screw technology, screws through the bone are threaded through slots in the nail, holding the bone rigid so it can heal in a once again functional leg.)