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Abstract Objective To explore the application of combining 3D-printed drill guide and digital technology in the treatment of complex talus fractures.Methods Thin-section CT data of 15 cases of talus fractures were obtained and imported into Mimics (Materialise's interactive medical image control system)，and three-dimensional (3D) models of fractures were reconstructed.The mean age was 36.8 (16~57)years，and there were 13 males and 2 females.Solidworks files of screws were drawn and imported into Mimics.Virtual reduction and internal fixation were performed in Mimics，which served as a guidance for operation in surgical approach，reduction，appropriate screw and angle of fixation.3D drill guides were designed and exported to Maker Bot Replicator Z18 3D printer，where 3D drill guides were printed.The postoperative X-ray were compared with digital models and the efficacy of combining 3D-printed drill guide and digital technologies was assessed.Long-term function of ankle joint was followed-up.Results Anatomic reduction was achieved in 10 cases，good reduction in 3 cases，fair reduction in 2 cases.The positions of internal fixation were very closed to preoperative planning.No screws penetrated into ankle joints and the lengths of screws are suitable.According to the AOFAS Ankle Hindfoot Scale，9 cases were excellent，4 cases were good and 2 cases were fair.Conclusion The 3D-printed drill guide and digital technologies provides an effective means for preoperative design，surgery simulation and accurate fixation of complex talus fractures.
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