Application of 3D-Printed Guide Rod-Assisted Screw Placement in Calcaneal Fractures

Wen Liang; Li Tao; Qian Zengjie; Yang Ke

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,Böhler 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 Böhler 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.