Forty-one displaced intraarticular fractures of the calcaneus in 38 patients were treated with open reduction and screw fixation of the posterior facet, bone grafting, and percutaneous pinning of the body. A single extensile posterolateral approach was used in all but two cases in which an additional medial incision was needed. Using early functional aftercare, all fractures healed without secondary displacement in an average of eight weeks. Follow-up periods averaged 4.2 years. Results were graded as excellent in 14 patients, good in 16, fair in three, and poor in five. There was a strict correlation between the clinical results and the severity of the articular comminution. A satisfactory outcome depended on the restoration of articular congruency and extraarticular alignment of the os calcis.