Objective To investigate the clinical efficacy of minimally invasive screw placement through tarsal sinus incicision combined with 3D printing visualization for calcaneous fracture. Methods Sixty patients with calcaneous fracture who received treatment at Jiujiang Hospital of Traditional Chinese Medicine from May 2020 to June 2023 were selected as the study objects. These patients were divided into the 3D printing group and the L-shaped incision group by the random number table method, with 30 patients in each group. The L-shaped incision group was treated with minimally invasive screw placement, and the 3D printing group was treated with minimally invasive screw placement after preoperative planning based on 3D printing technology. The surgical outcomes, pain status, ankle and foot joint functions, anatomical parameters of the calcaneus alignment, and the occurrence of complications were compared between the two groups of patients. Results The length of the surgical incision and the operation time in the 3D printing group were shorter than those in the L-shaped incision group, and the intraoperative blood loss in the 3D printing group was less than that in the L-shaped incision group, with all these differences being statistically significant (all P<0.05). One year after the operation, both the American Orthopaedic Foot and Ankle Society ankle-foot score and the Maryland score in the 3D printing group were higher than those in the L-shaped incision group, and the differences were statistically significant (all P<0.05). There were no statistically significant differences in calcaneal width, calcaneal height, Bohler's angle, and Gissane's angle between the two groups either before or after operation (all P>0.05). Compared with the preoperative state, in both groups after the operation, the calcaneal width became narrower, the calcaneal height increased, and both the Bohler's angle and Gissane's angle enlarged, with all the differences being statistically significant (all P<0.05). The incidence of postoperative complications was 6.67% (2/30) in the 3D printing group and 20.00% (6/30) in the L-shaped incision group, with no statistically significant difference between the two groups (P>0.05). Conclusions Minimally invasive screw placement through tarsal sinus incision combined with 3D printing visualization for treating calcaneous fractures can help shorten the operation time, reduce intraoperative blood loss, and promote the recovery of postoperative ankle and foot joint function in patients. 

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