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<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>September 19, 2007</span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>Dear Alex,</span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>It is always a pleasure to talk with you. I have noted that you are an
excellent surgeon by your discussion. There is such a demand now for SIGN to
treat the poor in developing countries that I want to be sure that each set if
being used to its potential. We now have 43 programs that have requested our
assistance and as you can imagine we must prioritize.</span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>The application form can be downloaded from our webpage if you have a
chance to do so. The instruments that you have are old and in poor repair as
you note. We have made many innovations since we first started. You have one
of our first sets.</span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>We had a workshop at Ilizarov by John Herzenberg, M.D. at the last SIGN
Conference. Eighty-percent of severe fractures occur in developing countries
and I am sure that more than eighty-percent of deformities follow a fracture occurring
in developing countries. I would like to somehow work out a way to correct
deformities using Ilizarov combined with SIGN nail. Do you have any ideas
about this?</span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>Have you done distraction treatment for osteoarthritis of the ankle?</span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>I would like to see your estimate on how much the SIGN equipment will
be used to treat the poor in Ural Scientific Institute. We would enjoy working
with you if there is a need in your institute.</span></font></p>
<p class=MsoNormal><font size=2 face="Times New Roman"><span style='font-size:
11.0pt'> </span></font></p>
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<p class=MsoNormal><font size=3 face=Times><span style='font-size:12.0pt;
font-family:Times'>Best regards, </span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
<p class=MsoNormal><font size=3 face=Times><span style='font-size:12.0pt;
font-family:Times'>Lew</span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
<p class=MsoNormal align=center style='text-align:center'><em><b><i><font
size=3 color="#004080" face="Times New Roman"><span style='font-size:12.0pt;
color:#004080;font-weight:bold'>SIGN</span></font></i></b></em><b><i><font
color="#004080"><span style='color:#004080;font-weight:bold;font-style:italic'><br>
<em><i><font face="Times New Roman">Creating Equality of Fracture Care </font></i></em><br>
<em><i><font face="Times New Roman">Throughout the World</font></i></em><br>
</span></font></i></b><em><i><font size=2 color="#800040" face=Arial><span
style='font-size:10.0pt;font-family:Arial;color:#800040'>Please visit our
website today </span></font></i></em><a href="http://www.sign-post.org"><em><i><font
size=2 color="#800040" face=Arial><span style='font-size:10.0pt;font-family:
Arial;color:#800040;text-decoration:none'>www.sign-post.org</span></font></i></em></a><i><font
size=2 color="#800040" face=Arial><span style='font-size:10.0pt;font-family:
Arial;color:#800040;font-style:italic'><br>
</span></font></i><strong><b><font size=2 color="#004080" face=Arial><span
style='font-size:10.0pt;font-family:Arial;color:#004080'>Lewis G. Zirkle, Jr.,
M.D., President and Founder</span></font></b></strong></p>
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<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
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