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目的:比较自行研制的跟骨内侧定位导向器辅助与徒手置入载距突螺钉在移位的跟骨关节内骨折(DIACF)治疗中的临床效果。方法:采用回顾性病例对照研究分析2016年7月至2018年6月山东大学齐鲁医院(青岛)收治的97例(110足)跟骨关节内骨折患者临床资料，其中男72例，女25例；年龄16～72岁[(41.7±12.7)岁]。均为新鲜骨折。49例(56足)置入载距突螺钉时采用自行研制的导向器辅助(A组)，48例(54足)徒手置入载距突螺钉(B组)。比较两组手术时间、载距突螺钉置入精确率及术后并发症；比较两组术前、术后1年跟骨B?hler角和Gissane角；末次随访时，采用Maryland足部评分系统比较两组功能恢复情况。结果:患者均获随访3～36个月[(20.1±8.3)个月]。两组手术时间差异无统计学意义(n P>0.05)。A组螺钉置入精确率为95%(53/56)，明显高于B组的69%(35/54)(n P0.05 )。A组45例(52足)、B组44例(49足)获得1年以上随访。术前、术后1年跟骨B?hler角和Gissane角两组间比较，差异均无统计学意义(n P>0.05)；而组内比较，差异有统计学意义(n P<0.05)。末次随访时，Maryland足部评分系统评分：A组优38足，良11足，可3足，优良率为94%；B组优26足，良9足，可14足，优良率为71%(n P0.05). The accuracy rate of screw placement in Group A was 95% (53/56), significantly higher than that in Group B [69%(35/54)](n P0.05). Forty-five patients (52 feet) in Group A and 44 patients (49 feet) in Group B were followed up for more than one year. The B?hler angle and Gissane angle in both groups were significantly improved after operation (n P0.05). According to the Maryland foot scoring system, 38 feet in Group A achieved excellent result, 11 good result, 3 fair result, with the excellent and good rate of 94%; 26 feet in Group B achieved excellent result, 9 good result, 14 fair result, with the excellent and good rate of 71% (n P<0.05).n Conclusion:In treatment of DIACF, our self-designed guider can significantly enhance the accuracy rate of sustentaculum tali placement without more operation time and enhance patients’ recovery after operation when compared with the free-hand technique.