Lewis Greer Zirkle Jr.

Lewis Greer Zirkle Jr (born July 23, 1940) is a board-certified orthopaedic surgeon known for developing surgical implants and curriculum for fracture care in low- and middle-income countries, or LMICs. Born in Pittsfield, Massachusetts, Zirkle attended Davidson College and Duke University School of Medicine. During his time in Medical School, he was drafted into the United States Army and served as an orthopaedic surgeon during the Vietnam War.

On January 29, 1999, Zirkle founded SIGN Fracture Care International (SIGN), a 501(c)(3) non- profit organization, aimed at aiding orthopaedic surgeons and patients in LMICs. Between 1972 and 2019, he traveled to 35 countries to teach surgery and orthopaedic care. In 2018 he was awarded the Department of Defense Medal for Distinguished Public Service for his work with the injured poor.

Biography Early life Zirkle was born in Pittsfield, Massachusetts, USA on July 23, 1940. He was the second son born to Lewis Zirkle Sr. and Vivian Shaw Zirkle. Zirkle grew up in North Carolina where his father was employed by General Electric. He attended Newton-Conover High School in Newton, North Carolina where he played football. As a teenager during the summers, Zirkle worked at a lumber mill stacking lumber, and later on wanted to become a carpenter.

Zirkle met his late wife Sara Kay Shilling while attending medical school. Sara was a year ahead of him and specialized in pediatric care, with a subspecialty in developmental behavior. They married in 1963 and had three daughters and nine grandchildren. Sara died on June 19, 2022.

Education Zirkle initially considered a career as a professional carpenter but chose to pursue higher education instead. He attended Davidson College on a football scholarship, where he began taking pre-med classes. Zirkle was accepted to Duke University Medical Center in Durham, North Carolina, as a medical student.

His military service included time treating military officials and civilian patients at the 93rd Evac Hospital in the Republic of Vietnam between 1968-1969 and at Fitzsimmons General Hospital in the United States between 1969-1970. Zirkle continued his orthopaedic residency while in the service at Letterman General Hospital between April 1970 to January 1971, Shriner's Hospital for Crippled Children between January 1971 to January 1972, and Fort Ord between January 1972 to April 1973. During his annual leave at Fort Ord in 1972, Zirkle and his wife Sara participated in a volunteer effort with CARE MEDICO in Indonesia, a program established by Dr. Tom Dooley. This initial volunteer experience inspired Zirkle to continue returning to Indonesia for many years following his leave from the military to heal patients and train doctors and medical students.

Orthopedic career Between 1973 and 2015, Zirkle worked in private orthopaedic practice until he retired in 2008 to focus on SIGN Fracture Care. In 1976, he helped build The Northwest Orthopaedic and Sports Medicine practice, that has since become a division of Kadlec Clinic.

Throughout his career, Zirkle used his vacation time to travel to low-and middle-income countries (LMICs) such as Indonesia and Vietnam, where he established a rapport with the local physicians. During one of his visits to Indonesia, he found that the supplies being donated to the hospital were not suitable to aid in the fracture care that was needed. He then devised a plan to provide medical supplies and tools to orthopaedic surgeons in these LMICs, enabling them to treat fracture patients without relying on traction.

Medical legacy Zirkle's contributions to orthopaedics in LMICs include creating medical instruments, such as target arms and slot finders, to replace the need for a C-arm in an operating room, as well as implants like intramedullary nails, plates, and screws for treating tibia, femur, and humerus fractures. His establishment of SIGN Fracture Care has facilitated the training and education of surgeons in LMICs on the SIGN Technique. Over the course of 25 years, Zirkle has trained over 5,000 surgeons and has helped to heal patients in more than 50 different LMICs. This initiative was developed to improve the healing process of fractured bones, aiming for optimal functional outcomes with minimal healing time and little to no financial burden on patients or their families.

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

SIGN Technique The SIGN Technique involves using specifically designed intramedullary nails that can be inserted without the need for advanced medical imaging equipment. This technique helps provide effective and affordable fracture care where resources are limited. Orthopaedic Trauma Association Lifetime Achievement Award (2022)