Anyone can say “expert surgeon.” X-rays don’t exaggerate. This portfolio shows the kind of work Dr. Panchal performs — organized into trauma, limb salvage, and elective surgery — in the most honest format there is: the before and after films themselves. It is written for referring providers, surgical colleagues, and hospital partners as much as for patients: proof, not promises.

All images are de-identified and shared with patient consent for education. Every case is different — nothing on this page is a guarantee of results. Click any film to enlarge it.

Fracture care & staged reconstruction

Trauma

From high-energy pilon fractures to severe forefoot trauma — staged, anatomic repair that restores the weight-bearing foot and ankle.

Pilon fracture — staged repair

Complex Ankle Fracture Reconstruction

High-energy pilon fractures shatter the weight-bearing surface of the ankle. Repair is staged: an external frame protects the soft tissue first, then the joint surface is rebuilt with anatomic plate-and-screw fixation. The external fixator looks dramatic — and it is doing exactly what it should: holding length and alignment while the soft tissues recover enough for definitive surgery.

At presentation — the shattered distal tibia, AP view

Injury film — lateral view of the fracture

Blurred clinical image — click to view — In the operating room — the external fixator being applied

Stage one on X-ray — external fixation, AP view

Definitive fixation — the joint surface rebuilt

Definitive fixation — hardware position confirmed

View more trauma cases

Same injury, different severity

A Second Pilon Fracture — Staged Repair

A less severe pilon fracture treated with the same staged philosophy — every fracture pattern gets a plan matched to its own severity and soft-tissue envelope.

Definitive plate fixation — lateral view

Severe forefoot trauma

First Metatarsal Fracture — Primary Fusion

A severe fracture of the first metatarsal left the joint surface unreconstructable. Primary fusion restored a stable, pain-free medial column — the definitive solution when the joint itself cannot be saved.

Before — the fractured first metatarsal at presentation

After — primary fusion with low-profile plate fixation

After — healed fusion, stable medial column

New cases are added regularly as Dr. Panchal prepares individual case write-ups.

Rebuilding feet others would amputate

Limb Salvage

Staged reconstruction and advanced grafting for infected bone and complex wounds — preserving structure, function, and the push-off that keeps people walking.

First metatarsal head osteomyelitis

Modified Masquelet — Saving the First Ray

A 57-year-old man with diabetes presented with an infected wound beneath the big-toe joint and osteomyelitis (bone infection) of the first metatarsal head. The traditional answer is a partial first ray amputation — removing the metatarsal head and the toe. Instead, the infected bone was removed, an antibiotic spacer placed in the void, a mini-rail external fixator applied to hold position, and a dermal substitute grafted into the cavity. The patient walked during treatment, the fixator came off in the office once the spacer absorbed — and the foot healed completely, toe preserved. This is truly limb salvage.

View more limb salvage cases

A large soft-tissue defect, healed

Gas Gangrene — Fragmented Fish-Skin Graft

Gas gangrene destroyed a large area of soft tissue, requiring a partial first ray resection and aggressive debridement. A fragmented fish-skin graft rebuilt the defect — healed over 25 weeks of staged care.

84-year-old, vascular disease

Chronic Ankle Wound — Staged Grafting

An 84-year-old man with diabetes and vascular disease presented with a chronic ankle wound after a vascular intervention. Staged debridement and four applications of a regenerative graft, closed definitively with a split-thickness skin graft.

Masquelet-type technique on X-ray

Staged Reconstruction Films

Radiographs from staged limb-salvage reconstruction: infected bone removed, the space held stable, and new bone grown in its place.

Staged reconstruction — comparison films

Lateral view with stabilizing fixation in place

External fixation holding alignment during healing

Follow-up lateral film of the reconstructed foot

Advanced imaging during staged reconstruction

New cases are added regularly as Dr. Panchal prepares individual case write-ups.

Planned correction, done right

Elective Surgery

Elective procedures — from bunion correction to soft-tissue excisions — planned on weight-bearing imaging and performed with the same rigor as complex trauma.

Bunion correction at its source — 32-year-old woman

Lapiplasty-Type First TMT Fusion

A 32-year-old woman with a painful, progressive bunion. A bunion is not a growth — it is a drifted first metatarsal. Triplanar correction with a first TMT fusion realigns the bone at its source and holds it there permanently, rather than shaving the bump and hoping. Protected walking begins early, and patients are typically back in regular shoes around six to eight weeks.

Before — weight-bearing AP view, the first metatarsal drifted

After — triplanar correction held with low-profile fixation

After — lateral view of the corrected first ray

Healed — the prominence gone because the bone is realigned

View more elective surgery cases

The fusion consolidating over time

Healing on X-ray: 4 Weeks, 6 Weeks, 3 Months

The same correction followed across three visits — watching the fusion consolidate from surgery to full healing.

Correction that holds

One-Year Follow-Up

A first TMT fusion at one year — the correction unchanged, the fusion solid, the patient in regular shoes.

One-year follow-up — correction maintained

Early return to activity

Bunion Correction — 29-Year-Old Woman

A 29-year-old woman with a symptomatic bunion — corrected, fused, and back to activity with the deformity addressed at its source.

New cases are added regularly as Dr. Panchal prepares individual case write-ups.

The next good result could be yours

An exam and weight-bearing X-rays tell us exactly what your foot needs — usually in a single visit.

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