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目的：跟骨解剖形态复杂、结构不规则，骨折多累及关节面，且致伤后关节面压缩、塌陷、粉碎严重，传统手术术区显露较局限，骨折复位较困难，关节面复位精度不高，手术时间较长，致残率高。探讨快速成型技术治疗跟骨关节内骨折的应用价值。方法：将2012 年1 月～2013 年1 月期间收治的30 例SandersⅢ-Ⅳ跟骨骨折患者根据入院顺序随机均分为试验组和对照组两组，对试验组患者采用计算机辅助技术行跟骨骨折的三维重建解剖学模型，快速成型制作出与实体1：1 大小的跟骨模型。依此对跟骨骨折做出明确的诊断、分型，制定手术方案，术前模拟手术，指导手术治疗，将术中指标与未模拟手术的对照组指标进行比较。结果：试验组和对照组的手术时间分别为(53.3± 5.0) min 和(71.4± 4.9) min，两组间差异有统计学意义(P<0.05)。试验组和对照组术中出血量分别为(47.3± 6.8) mL和(51.3± 8.4) mL，两组间差异无统计学意义(P＞0.05)。试验组术后功能评分：优良率88.2 %，而对照组为88.9 ％，两组间差异无统计学意义(P>0.05)。结论：快速成型技术能够向术者直观、立体的展示骨折的形态，使术者准确评估骨折情况，弥补术区切口显露局限的不足，提高复位精度，缩短手术时间，减少术中创伤，降低致残率，对跟骨骨折的治疗有很强的指导意义、应用前景广阔。

英文摘要:

Objective:The calcaneal anatomic has complex forms and irregular structure. The fracture often leads to the collapsed and crushed articulation surface. The traditional surgery exposed many problems, such as limited incision, hard to reduce fracture, low reduction accuracy of articular surface, long operation as well as high morbidity. This article aims to investigate the value of application of rapid prototype technology in therapy of intra-articular calcaneal fractures.Methods:In this study, 30 patients hospitalized during January 2012 and January 2013 with calcaneal fractures and sanders type Ⅲ-Ⅳ, were randomly and equally divided into the test group and the control group according to their hospitalized order. The test group was treated with three-dimensional reconstructions of anatomical models which were accomplished by computer aided technology. Using rapid prototyping technology to form the calcaneal models, which need to be carefully diagnosed and grouped. Then, the operation plan was formulated based on it. And surgery simulation was applied before the real one to give instructions for the operative treatment. The index during the operation needed to compare with the ones that had none surgery simulation applied by the control group.Results:The operation time of test group and the control group were respectively (53.3± 5.0) min and (71.4± 4.9) min. Difference had statistical significance (P<0.05) between the two groups. The blood loss amount of the test group and control group were respectively (47.3± 6.8) mL and (51.3± 8.4) mL. There was no statistical difference (P>0.05) between the two groups. The function assessment after operation of the test group was 88.2%(the excellent and good rate) and of the control group was 88.9 %. There was no statistical difference (P>0.05) between the two groups.Conclusion:Rapid prototype technology can display the fracture form intuitively and stereoscopically. It helps the operators make accurate assessment of the fractures situation, redeemthe inadequacy of the area incision, raise the accuracy of the reduction and reduce both operative time and the intro-operative trauma. It has strong leading significance for the calcaneal fractures treatment and a broad application perspectives.

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