Population Characteristics and Clinical Outcomes From the SIGN Online Surgical Database

Summary: There are over 26,000 cases recorded in the SIGN Online Surgical Database (SOSD). Though follow-up is limited, there is an abundance of data describing the population being treated and the resultant outcomes. Furthermore, given the lack of evidence available, the clinical outcomes reported in the database are a first step toward understanding the safety and efficacy of Surgical Implant Generation Network (SIGN) nailing. Methods: All data from the SOSD from 2003 to August 2009 were included in the study. The primary outcome considered was the rate of deep infection. Results: The majority of patients were young men. Over 20% of patients had a delay of greater than 10 days from the time of the injury to surgery, and more than 5% were considered a nonunion preoperatively. Femoral shaft fractures were the most common indication for SIGN nailing. The infection rate was less than 2% for closed fractures and between 5% to 7% for open fractures. The number of patients with documented full painless weight bearing increased dramatically with more recent surgery. Discussion: Operative intervention has significant potential to reduce the burden of long-bone fractures at the familial and societal level. The infection rate was comparable to studies published in the Western literature. The weight bearing data are unlikely to be of clinical significance. Conclusion: There is a tremendous amount of data regarding patients treated with SIGN nails in the SOSD. With improvement in clinical follow-up, this will be invaluable in assessing the safety and efficacy of SIGN nailing and addressing important clinical questions.