Objective To investigate the application of 3D printing combined with wrist arthroscopy in treatment of distal radius fracture involving articular surface with fully minimally invasive precise reduction and percutaneous internal fixation. Methods From January to December 2020, 30 patients with distal radius fracture involving articular surface admitted to Foshan Shunde Heping Surgical Hospital, Guangdong Province were selected as the research objects. They were divided into control group and observation group by random number table method, with 15 cases in each group. Patients in the control group were treated with open reduction and internal fixation, while patients in the observation group were treated with 3D printing combined with wrist arthroscopy for total minimally invasive precise reduction and percutaneous internal fixation. The clinical indicators of treatment (length of hospital stay, surgical treatment cost, fracture healing time), wrist function (Gart-Land-Werley score, wrist range of motion) and postoperative pain (visual analogue scale [VAS] score) were compared between the two groups. Results The hospital stay and fracture healing time of the observation group were shorter than those of the control group, and the cost of surgical treatment was lower than that of the control group, and the differences were statistically significant (P＜0.05). There were no significant differences in preoperative Gart-land-Werley score and wrist range of motion between the two groups (P＞0.05). At 6 months after operation, the Gart-land-Werley score of wrist in the observation group was lower than that in the control group, and the wrist range of motion was higher than that in the control group, and the differences were statistically significant (P＜0.05). The VAS score of the observation group was lower than that of the control group 3 d after operation, and the difference was statistically significant (P＜0.05). Conclusion The clinical treatment of distal radius fracture involving articular surface can be combined with 3D printing and fully minimally invasive precise reduction of wrist and percutaneous internal fixation. The surgical operation is more accurate, and the length of hospital stay can be shortened. The medical expenses of patients can be reduced, and the wrist function can recover better. The therapeutic effect of this method can be ensured.