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Editor’s Note: Orthopedics has the remarkable ability to restore movement — and life — for patients who are fortunate enough to receive care. We seek to play a role in expanding access to care for patients in low- and middle-income countries by donating to SIGN Fracture Care International. Proceeds from every OMTEC registration completed in May will be donated to SIGN, with additional giving back opportunities taking place at OMTEC in June. Read our interview with SIGN’s CEO and join us in creating meaningful global impact for orthopedic patients.
Sariah Khormaee, M.D., Ph.D., was always interested in SIGN Fracture Care International’s mission to deliver worldwide high-quality fracture care in a way that’s practical and inclusive. It makes sense then that she took over as the organization’s CEO in August 2025.
Before joining SIGN, Dr. Khormaee was an attending spine surgeon and researcher at the Hospital for Special Surgery and an Assistant Professor at Weill Cornell Medical College. She earned her Ph.D. from Cambridge University in Chemical Engineering and Biotechnology, and has collaborated with global health nonprofits, founded a research education organization, and traveled to orthopedic hospitals across the world, including SIGN sites in Ghana, Myanmar and Vietnam.
Now, Dr. Khormaee oversees advancing SIGN’s mission to develop innovative device designs and deliver on the organization’s goal to reach more patients with life-saving care.
When did you learn about SIGN’s mission, and why did you first get involved in the organization?
Dr. Khormaee: I became interested in orthopedics when I was a medical student and saw a SIGN nail implanted in Vietnam. I was working on an engineering-related research project but happened to be in the operating room when they treated a young woman with a tibia fracture.
The surgeon held up the nail and told me it was designed by SIGN and donated because the patient couldn’t afford it. I thought that was incredible. Seeing her recover and regain the ability to walk was amazing.
I stayed in touch with the program and visited one of its locations in Myanmar, where I met an incredible surgeon who not only achieves excellent outcomes but also trains other surgeons to perform SIGN procedures.
His surgical skills and his dedication to the mission struck me, and the hospital conditions were extremely challenging. Patients were packed in crowded rooms, and even on balconies, with limited nursing support, so family members were helping care for them.
Without SIGN, those patients would have had to purchase their own implants, often at a cost of many times their daily income. Seeing that reality firsthand, and how SIGN impacts the lives of patients and their families, was inspirational.
How did your journey evolve into becoming SIGN’s CEO?
Dr. Khormaee: I stayed involved in the program, volunteering on the technical and engineering side of things. As my training progressed and I became a spine surgeon, I also contributed to the early SIGN Spine initiative. When the CEO position became available, it felt like an incredible opportunity to serve an organization I deeply believe in.
It’s a real honor to now lead the organization, and it’s been incredibly rewarding to work with people who share a common mission and focus on treating as many patients as possible. Bringing together diverse perspectives to achieve that goal is very powerful, and figuring out how to get it done effectively is something I’m passionate about as a leader.
Why does SIGN place a strong emphasis on partnering with surgeons who are interested in compassionate work?
Dr. Khormaee: That’s one of the things that makes SIGN special. Many organizations focus on orthopedic excellence, which is important, but SIGN goes further by focusing on patients who otherwise wouldn’t receive treatment.
That requires a different mindset. We must understand the challenges in low-resource settings and ask how we can help people return to work and avoid falling into generational poverty. Finding surgeon partners who share that perspective is critical to our mission.
One key initiative is our “traveling sets” program. Experienced SIGN surgeons travel within their region to hospitals interested in starting a program. They bring instruments and implants and mentor local surgeons through procedures and follow-up care. They then leave the instruments behind and continue providing remote mentorship. All cases are reviewed through our database, so surgeons receive one-on-one feedback.
We’re working to strengthen this program and expand our network of surgeon mentors in areas with the greatest need, including regions affected by conflict, such as parts of the Middle East, as well as highly populous countries where access to care is limited, like Nigeria and parts of Latin America. Even in areas where we already have programs, there’s often room to grow our network of surgeons.
SIGN’s engineering approach is unique. How does your team tackle innovation?
Dr. Khormaee: Orthopedics is fundamentally engineering. It involves material science, matching implants to bone, ensuring proper integration and achieving mechanical stability for healing. Having dual training in engineering and surgery allows me to better identify problems and opportunities. I can see challenges firsthand in the clinical setting and then apply engineering tools, or collaborate with our engineering team, to develop solutions.
The SIGN System enables surgeons in low- and middle-income countries to treat long bone fractures with intramedullary nailing. SIGN makes it accessible to hospitals that do not have C-arms or reliable electricity in the operating room.
Our model is designed to be adaptable. It’s very elegant in its simplicity and makes our products effective not only in low- and middle-resource countries, but also in conflict zones and areas affected by natural disasters.
Everyone has a shared belief in the mission, which drives what we do and requires creativity across all areas, from engineering and manufacturing to quality, IT and administration. The shared belief in the mission drives innovation, especially when designing implants that are versatile, cost-effective and accessible to so many.
Our goal is to expand SIGN’s reach into areas like articular fractures, improving solutions for proximal femur fractures and continuing to refine what we already offer. How can we build on that to find more creative engineering solutions for multi-use implants? That work will involve expanding the program’s global reach and continuing to innovate on the engineering side by staying true to SIGN’s DNA of simple, versatile implants that can be used in low-resource settings.
What role do industry partnerships play in supporting SIGN’s work?
Dr. Khormaee: They’re essential. We collaborate with OEMs and industry experts across areas like supply chain, regulatory strategy and manufacturing efficiency, which are always a priority. One of our major advancements last year involved implementing a new horizontal milling machine that significantly improved the volume of what we could produce. We also benefit from financial support and employee engagement donation programs, which help sustain our mission.
We’re interested in optimizing the integration between software and manufacturing systems, such as ERP tools. Engineering innovation is another key area, especially ideas for new products or solutions suited to low-resource settings. We could also use help navigating regulatory environments in low- and middle-income countries.
How has SIGN benefited from its involvement with OMTEC?
Dr. Khormaee: It’s been extremely important, especially for our team members who attended the conference last year. They built strong connections with industry experts and gained insights into instrument tray design, manufacturing efficiency and sourcing components.
Those connections and lessons had a meaningful impact on how we operate.
This article was originally published in BONEZONE.
Editor’s Note: Orthopedics has the remarkable ability to restore movement — and life — for patients who are fortunate enough to receive care. We seek to play a role in expanding access to care for patients in low- and middle-income countries by donating to SIGN Fracture Care International. Proceeds from every OMTEC registration completed in May...
Editor’s Note: Orthopedics has the remarkable ability to restore movement — and life — for patients who are fortunate enough to receive care. We seek to play a role in expanding access to care for patients in low- and middle-income countries by donating to SIGN Fracture Care International. Proceeds from every OMTEC registration completed in May will be donated to SIGN, with additional giving back opportunities taking place at OMTEC in June. Read our interview with SIGN’s CEO and join us in creating meaningful global impact for orthopedic patients.
Sariah Khormaee, M.D., Ph.D., was always interested in SIGN Fracture Care International’s mission to deliver worldwide high-quality fracture care in a way that’s practical and inclusive. It makes sense then that she took over as the organization’s CEO in August 2025.
Before joining SIGN, Dr. Khormaee was an attending spine surgeon and researcher at the Hospital for Special Surgery and an Assistant Professor at Weill Cornell Medical College. She earned her Ph.D. from Cambridge University in Chemical Engineering and Biotechnology, and has collaborated with global health nonprofits, founded a research education organization, and traveled to orthopedic hospitals across the world, including SIGN sites in Ghana, Myanmar and Vietnam.
Now, Dr. Khormaee oversees advancing SIGN’s mission to develop innovative device designs and deliver on the organization’s goal to reach more patients with life-saving care.
When did you learn about SIGN’s mission, and why did you first get involved in the organization?
Dr. Khormaee: I became interested in orthopedics when I was a medical student and saw a SIGN nail implanted in Vietnam. I was working on an engineering-related research project but happened to be in the operating room when they treated a young woman with a tibia fracture.
The surgeon held up the nail and told me it was designed by SIGN and donated because the patient couldn’t afford it. I thought that was incredible. Seeing her recover and regain the ability to walk was amazing.
I stayed in touch with the program and visited one of its locations in Myanmar, where I met an incredible surgeon who not only achieves excellent outcomes but also trains other surgeons to perform SIGN procedures.
His surgical skills and his dedication to the mission struck me, and the hospital conditions were extremely challenging. Patients were packed in crowded rooms, and even on balconies, with limited nursing support, so family members were helping care for them.
Without SIGN, those patients would have had to purchase their own implants, often at a cost of many times their daily income. Seeing that reality firsthand, and how SIGN impacts the lives of patients and their families, was inspirational.
How did your journey evolve into becoming SIGN’s CEO?
Dr. Khormaee: I stayed involved in the program, volunteering on the technical and engineering side of things. As my training progressed and I became a spine surgeon, I also contributed to the early SIGN Spine initiative. When the CEO position became available, it felt like an incredible opportunity to serve an organization I deeply believe in.
It’s a real honor to now lead the organization, and it’s been incredibly rewarding to work with people who share a common mission and focus on treating as many patients as possible. Bringing together diverse perspectives to achieve that goal is very powerful, and figuring out how to get it done effectively is something I’m passionate about as a leader.
Why does SIGN place a strong emphasis on partnering with surgeons who are interested in compassionate work?
Dr. Khormaee: That’s one of the things that makes SIGN special. Many organizations focus on orthopedic excellence, which is important, but SIGN goes further by focusing on patients who otherwise wouldn’t receive treatment.
That requires a different mindset. We must understand the challenges in low-resource settings and ask how we can help people return to work and avoid falling into generational poverty. Finding surgeon partners who share that perspective is critical to our mission.
One key initiative is our “traveling sets” program. Experienced SIGN surgeons travel within their region to hospitals interested in starting a program. They bring instruments and implants and mentor local surgeons through procedures and follow-up care. They then leave the instruments behind and continue providing remote mentorship. All cases are reviewed through our database, so surgeons receive one-on-one feedback.
We’re working to strengthen this program and expand our network of surgeon mentors in areas with the greatest need, including regions affected by conflict, such as parts of the Middle East, as well as highly populous countries where access to care is limited, like Nigeria and parts of Latin America. Even in areas where we already have programs, there’s often room to grow our network of surgeons.
SIGN’s engineering approach is unique. How does your team tackle innovation?
Dr. Khormaee: Orthopedics is fundamentally engineering. It involves material science, matching implants to bone, ensuring proper integration and achieving mechanical stability for healing. Having dual training in engineering and surgery allows me to better identify problems and opportunities. I can see challenges firsthand in the clinical setting and then apply engineering tools, or collaborate with our engineering team, to develop solutions.
The SIGN System enables surgeons in low- and middle-income countries to treat long bone fractures with intramedullary nailing. SIGN makes it accessible to hospitals that do not have C-arms or reliable electricity in the operating room.
Our model is designed to be adaptable. It’s very elegant in its simplicity and makes our products effective not only in low- and middle-resource countries, but also in conflict zones and areas affected by natural disasters.
Everyone has a shared belief in the mission, which drives what we do and requires creativity across all areas, from engineering and manufacturing to quality, IT and administration. The shared belief in the mission drives innovation, especially when designing implants that are versatile, cost-effective and accessible to so many.
Our goal is to expand SIGN’s reach into areas like articular fractures, improving solutions for proximal femur fractures and continuing to refine what we already offer. How can we build on that to find more creative engineering solutions for multi-use implants? That work will involve expanding the program’s global reach and continuing to innovate on the engineering side by staying true to SIGN’s DNA of simple, versatile implants that can be used in low-resource settings.
What role do industry partnerships play in supporting SIGN’s work?
Dr. Khormaee: They’re essential. We collaborate with OEMs and industry experts across areas like supply chain, regulatory strategy and manufacturing efficiency, which are always a priority. One of our major advancements last year involved implementing a new horizontal milling machine that significantly improved the volume of what we could produce. We also benefit from financial support and employee engagement donation programs, which help sustain our mission.
We’re interested in optimizing the integration between software and manufacturing systems, such as ERP tools. Engineering innovation is another key area, especially ideas for new products or solutions suited to low-resource settings. We could also use help navigating regulatory environments in low- and middle-income countries.
How has SIGN benefited from its involvement with OMTEC?
Dr. Khormaee: It’s been extremely important, especially for our team members who attended the conference last year. They built strong connections with industry experts and gained insights into instrument tray design, manufacturing efficiency and sourcing components.
Those connections and lessons had a meaningful impact on how we operate.
This article was originally published in BONEZONE.
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Dan Cook is a senior editor with more than 18 years of experience in medical publishing and an extensive background in covering orthopedics and outpatient surgery. He joined ORTHOWORLD to develop content focused on important industry trends, top thought leaders and innovative technologies.
