Abstract: Objective To compare the clinical efficacy of tarsal sinus approach combined with special plate versus traditional "L" type expanded approach combined with conventional plate in treatment of calcaneal posterior articular surface collapse fracture,so as to provide a reliable theoretical evidence for clinical application. Methods A retrospective analysis was performed in 28 patients with calcaneal fractures from January 2017 to January 2018 in our hospital,and the patients were divided into the tarsal sinus group (n=13) and the "L" incision group (n=15).Patients in the tarsal sinus group were treated with special steel plate and the traditional "L" incision group with the conventional plate.Clinical data,including Böhler Angle,Gissane Angle,varus Angle,operating time,incision length,AOFAS score of the last follow-up and incision complications,were analyzed. Results The postoperative Böhler Angle,Gissane Angle and varus Angle of the tarsal sinus group improved significantly compared with before operation (P<0.05),but there was no significant difference between postoperation and the last follow-up (P>0.05).At each time point,the tarsal sinus group and the "L" incision group had no significant difference in the indicators mentioned above (P>0.05).However,the tarsal sinus group was superior to the "L" incision group in operative time (9.07±1.71 d vs 10.67±1.50 d),operative duration (115.15±27.56 min vs 141.73±35.41 min),incision length (5.46±0.52 cm vs 15.13±1.06 cm) and incision complication rate (0 vs 20%) (P<0.05).No significant difference was found in AOFAS score (P>0.05). Conclusion The special tarsal sinus plate can firmly fix calcaneal fractures and achieve good functional rehabilitation.Meanwhile,the tarsal sinus approach has many advantages,such as small incision,short operating time and few complications,which is worthy of clinical promotion.