【摘要】 目的 探讨3D打印导杆辅助置入通道螺钉治疗跟骨骨折中的应用价值。方法 前瞻性分析2020年10月至2025年3月宿迁市钟吾医院收治的132例跟骨骨折患者资料，其中男85例，女47例；年龄45～68岁，平均(55.32±6.84)岁。按照1︰1随机配对分组，每组各66例。常规组给予常规切开复位或经跗骨窦切口微创有限切开复位，3D组在常规组基础上给予3D打印导杆辅助置入通道螺钉。比较两组螺钉精准置入率、围术期指标、跟骨外形指标(跟骨宽度、B9hler角、Gissane角)、美国足踝外科协会(American orthopaedic foot and ankle society, AOFAS)评分、Maryland评分及并发症发生率。结果 术后随访时间≥6个月。3D组螺钉精准置入率(98.48%)高于常规组(83.33%),差异有统计学意义(P<0.05)。3D组的术中出血量、术中透视次数、术后引流量、手术时间、住院时间、骨折愈合时间均少于常规组(P<0.05)。术后3、6个月，3D组的跟骨宽度、Gissane角均小于常规组，B9hler角大于常规组，AOFAS评分、Maryland评分均高于常规组(P<0.05)。3D组并发症总发生率(4.55%)显著低于常规组(18.18%),差异有统计学意义(P<0.05)。结论 相对于常规术式治疗跟骨骨折，3D打印导杆辅助置入通道螺钉能提高螺钉精准置入率、缩短手术时间，减轻创伤应激，减少并发症。更多还原

【Abstract】 Objective To explore the application value of 3D-printed guide rod-assisted cannulated screw placement in the treatment of calcaneal fractures.Methods A prospective analysis was conducted on the data of 132 patients with calcaneal fractures admitted to Zhongwu hospital in Suqian from October 2020 to March 2025,including 85 males and 47 females, aged 45 to 68 years[mean age(55.32±6.84)years].The patients were randomly assigned in a 1︰1 ratio to two groups, with 66 cases in each group.The conventional group underwent routine open reduction or minimally invasive limited open reduction via the sinus tarsi approach, while the 3D group received 3D-printed guide rod-assisted insertion of channel screws in addition to the conventional method.The study compared the precise screw placement rates, perioperative indicators, Calcaneal width, B9hler angle, Gissane angle, American orthopaedic foot and ankle society(AOFAS) scores, Maryland scores, and complication rates between the two groups.Results Postoperative follow-up time≥6 months.The accurate placement rate of 3D group screws(98.48%) was significantly higher than that of the conventional group(83.33%)(P<0.05).The operative time, hospitalization duration, fracture healing time, intraoperative blood loss, number of intraoperative fluoroscopies, and postoperative drainage volume in the 3D group were all lower than those in the conventional group(P<0.05).At 3 and 6 months postoperatively, the 3D group exhibited smaller calcaneal width and Gissane angle but larger B9hler angle, along with higher AOFAS and Maryland scores compared to the conventional group(P<0.05).The overall complication rate in the 3D group(4.55%) was significantly lower than that in the conventional group(18.18%)(P<0.05).Conclusion For the treatment of calcaneal fractures, compared to conventional surgical procedures, 3D printed guide rod assisted insertion of channel screws can improve screw placement accuracy, reduce surgical time, alleviate traumatic stress, and reduce complications.更多还原