Every year, thousands of children are born with clubfoot, and nearly 80% live in low- and middle-income countries (LMICs). The Ponseti Method is the gold standard for treatment, but it requires accurate decisions at each stage—manipulation, casting, tenotomy, bracing, and sometimes surgery. Errors can occur anywhere in the world, and even a single misstep can lead to relapse, delays, or long-term disability.

     Clubfoot is not a single condition but a group of types—idiopathic, syndromic, atypical, complex, recurrent, post-surgical, and more—each with unique treatment protocols. Over at least four years and about 20 follow-up visits, providers must make consistent, precise choices that shape a child’s outcome. Without strong training, data systems, and support, errors in scoring, casting, and record-keeping are common, leading to poor long-term results.

     The Ponseti Clubfoot Navigator (PCN) was created to address these challenges. PCN is a mobile digital health platform that works as both an electronic medical record and a real-time clinical decision-support tool.

     Built with evidence-based Ponseti algorithms and an inferencing engine, it acts like a “GPS” for clinicians, guiding them through each treatment phase. Designed for use on smartphones and tablets, even in low-resource settings, PCN reduces errors, standardizes care, and helps ensure that children everywhere receive effective treatment for clubfoot.

     In the real world there is inconsistency, lack of standardization and high error rate in the practice of the Ponseti method. Children unnecessarily suffer from prolonged treatment and poorer outcomes.

     After observing the high rate of errors in treatment, PCN was developed by Pankaj Jain, a technologist based out of Delhi, India. In 2015, he started collaborating with Dr. Mathew Varghese (Director of the National Clubfoot Program in India), spending 18 months learning about clubfoot treatment. In 2017, Dr. Shafique Pirani joined this initiative and along with Jain, further developed and refined the platform.

     Dr Pirani, working with Dr. Ignacio Ponseti, took the Ponseti method and in 1998 introduced it to Uganda and subsequently to Bangladesh. He is well known for the Pirani Score for Ponseti clubfoot treatment and as part of the team that developed the Ponseti International Guidelines published in 2015.

     Ponseti Clinical Navigator is a Clinical Decision Support Platform that is cloud-based that can be used on any mobile device or computer.

     In testing PCN, the AI’s decision making was thoroughly compared to decisions made by Ponseti experts. With 781 visits, and 2215 decisions made by experts, PCN had a 96% decision accuracy. Specifically, PCN made the same decisions 2127 out of 2215 decisions. 

     A survey conducted with 68 medical professionals aided by PCN, ~81% concluded that PCN does improve treatment decisions with an improvement in comfortability using the app at 95.6%. 47.1% of of the users agreed the usage of PCN saved them time during the treatments.