Objective: To investigate the effect of transtarsal sinus small incision internal fixation for Sander II~III calcaneal fracture. Methods: A total of 84 patients with Sander II~III calcaneal fractures admitted to Department of Orthopaedics from January 2017 to December 2017 were randomly divided into a control group and a study group, 42 cases in each group. The control group was treated with classical lateral “L” incision, while the study group was treated with transtarsal sinus incision internal fixation. Radiographic evaluation of bone anatomical measurement data before and after operation. The outpatient follow-up was 6 months. AOFAS score and VAS score were used to evaluate the effect of the operation, and the complications were counted. Results: The intraoperative bleeding volume and drainage volume in the study group were lower than those in the control group (P<0.05). There was no significant difference in the improvement of Bohler angle, Cissane angle and the width of the middle calcaneus between the two groups (P>0.05). At the end of 6-month follow-up, there was no significant difference in American Orthopaedic Foot & Ankle Society (AOFAS) score and Visual Analogue Scale (VAS) score between the two groups (P>0.05), and the complication rate in the study group was lower than that in the control group (P<0.05). Conclusion: Transtarsal sinus incision internal fixation for Sander II~III calcaneal fracture can not only achieve the same surgical effect as classical lateral “L” incision, but also have obvious advantages in operative bleeding volume, drainage volume and complications. It has significant clinical application value.