软组织的有限覆盖和复杂的生物力学因素使得远端胫骨肿瘤的切除和重建极具挑战性。巨型假体可为肿瘤整块切除提供良好的机械强度，但术后并发症较多，且必须解决软组织覆盖不足和术后踝关节不稳等问题。三维数字技术的发展可能为胫骨远端重建提供新的治疗策略。与保留踝关节的内置假体相比，三维打印巨型假体与踝关节融合术的快速骨整合效果提供了更好的踝关节稳定性和术后功能。此外，三维打印巨型假体可以通过个性化设计减小假体周长并与距骨匹配，从而改善软组织覆盖不足、距骨塌陷等并发症。当然，关于远端胫骨假体的研究报道还很少，三维打印巨型假体结合踝关节的安全性需要通过广泛的长期随访研究来证实。假体近端和远端固定方法的选择需要在未来的研究中进行探索。

The limited coverage of soft tissue and complex biomechanical factors make resection and reconstruction of distal tibial tumors extremely challenging. Megaprosthesis can provide good mechanical strength for tumor en bloc resection, but there are many postoperative complications, and the problems of insufficient soft tissue coverage and postoperative ankle instability must be solved. The development of three-dimensional digital technology may provide a new treatment strategy for distal tibial reconstruction. Compared to ankle joint preservation endoprostheses, the rapid osseointegration effect of three dimensional-printed megaprosthesis with ankle arthrodesis provides better ankle joint stability and postoperative function. In addition, the three dimensional-printed megaprosthesis may improve complications such as insufficient soft tissue coverage and talus collapse by reducing the circumference of the prosthesis and matching it with the talus through personalized design. Of course, there are few research reports on distal tibial prostheses, and the safety of three dimensional-printed megaprosthesis with ankle arthrodesis needs to be confirmed through extensive long-term follow-up studies. The selection of proximal and distal fixation methods for prostheses needs to be explored in future research.