Objective To investigate the efficacy of three-dimensional (3D) printing used to assist the treatment of pilon fracture combined with ipsilateral tibial shaft fracture.Methods From May to July 2016,3 patients with pilon fracture combined with ipsilateral tibial shaft fracture were treated at Department of Traumatic Orthopedics,The Second Affiliated Hospital,University of South China.They were all male,aged from 26 to 47 years.They all had preoperative 3D CT scan.Their CT data were imported to Mimics software for 3D reconstruction.After their fracture 3D models were manufactured by 3D printing,precise patient-specific surgical plans were made to guide their actual operations.Postoperatively,Johner-Wruhs scores were used to evaluate the treatment of tibial shaft fracture,Burwell-Charnley scores to evaluate the treatment of pilon fracture and Tornetta scores to evaluate the therapeutic outcomes.Results All the operations were performed according to the patient-specific surgical plans designed preoperatively.All the fractures achieved bony union without any infection,exposure of bone or internal fixation,osteofascial compartment syndrome or neurovascular injury.The outcomes of tibial shaft fracture were excellent by Johner-Wruhs scoring,anatomic reduction was achieved for pilon fractures by Burwell-Charnley scoring and the therapeutic outcomes were excellent by Tornetta scoring.Conclusion In the treatment of pilon fracture combined with ipsilateral tibial shaft fracture,3D printing can help making of precise and patient-specific surgical plans to promote clinical efficacy.