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The Role of SIGN in the Development of a Global Orthopaedic Trauma Database

  • Symposium: ABJS Carl T. Brighton Workshop on Health Informatics
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The global burden of injury is receiving recognition as a major public health problem but inadequate information delays many proposed solutions. Many attempts to collect reliable data on orthopaedic trauma have been unsuccessful. The Surgical Implant Generation Network (SIGN) database is one of the largest collections of fracture cases from lower and middle income countries.

Questions/purposes

We describe the information in the SIGN database then address two questions: In the context of the design and implementation of a global trauma database, what lessons does the SIGN database teach? Does the SIGN program have a role in the evolution of a wider global system?

Methods

The SIGN database is Internet based. After treating a patient with a SIGN nail surgeons enter radiographs and details of the case.

Results

Over 26000 cases are in the SIGN database. The database has been used as a source of cases for followup studies. Analysis shows the data are of sufficient quality to allow studies of fracture patterns but not for outcome studies or bone measurement.

Where do we need to go?

A global database with more comprehensive coverage of injuries, causes, treatment modalities and outcomes is needed.

How do we get there?

The SIGN database itself will not become a global trauma database (GTD) but the personnel of the SIGN program have much to offer in the design and adoption of a GTD. Studies of suitable methods of data collection and the incentive to use them are required.

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Acknowledgments

We thank the surgeons of the SIGN program for their diligence in entering data into the SIGN database.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of British Columbia, 198 Waddington Drive, Kamloops, Vancouver, BC, V2E 1M4, Canada

    John F. Clough MD, DPhil

  2. Surgical Implant Generation Network, Richland, WA, USA

    Lewis G. Zirkle MD & Robert J. Schmitt

Authors
  1. John F. Clough MD, DPhil
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  2. Lewis G. Zirkle MD
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  3. Robert J. Schmitt
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Corresponding author

Correspondence to John F. Clough MD, DPhil.

Additional information

SIGN (Surgical Implant Generation Network) is registered as a nonprofit, tax-exempt corporation in the state of Washington and in the United States with IRS 501(c)(3) status. LGZ is the President of SIGN. RJS is employed by SIGN.

This work was performed in Canada using the SIGN database located in the United States.

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Clough, J.F., Zirkle, L.G. & Schmitt, R.J. The Role of SIGN in the Development of a Global Orthopaedic Trauma Database. Clin Orthop Relat Res 468, 2592–2597 (2010). https://doi.org/10.1007/s11999-010-1442-1

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  • DOI: https://doi.org/10.1007/s11999-010-1442-1

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