Abstract:[Objective] To compare the clinical efficacy of percutaneous reduction and fixation (PRF) versus conventional open reduction and internal fixation (ORIF) in the treatment of joint surface collapse-type calcaneal fractures. [Methods] A retrospective study was conducted on 59 patients who received surgical treatments for subtalar collapse-type calcaneal fractures (Sanders Ⅱ-Ⅲ type) from January 2022 to June 2023. According to the communication between doctors and patients, 30 patients were treated with PRF, while the other 29 patients underwent conventional ORIF. The perioperative, follow-up and imaging documents of the two groups were compared. [Results] All patients in both groups had corresponding surgical procedures performed successfully. The PRF group proved significantly superior to the ORIF group in terms of operation time [min, (20.5±9.1) vs (87.2±8.7), P<0.001], the total incision length [cm, (2.1±0.2) vs (13.8±1.4), P<0.001], the intraoperative blood loss [mL, (10.5±3.3) vs (61.2±7.4), P<0.001] and the hospital stay [d, (8.4±1.7) vs (16.7±2.9), P<0.001]. However, there was no statistically significant difference in the number of intraoperative fluoroscopy and the incision healing grade between the two groups (P>0.05). The average follow-up time of the patients was of (18.4 ± 4.3) months, and there was no a statistically significant difference in the time to resume ambulation and the full weight-bearing activities between the two groups (P>0.05). The VAS scores, AOFAS scores, and the inversion-eversion ROM significantly improved in both groups over time (P<0.05). The VAS score in PRF group was significantly less than that in the ORIF group 1 day postoperatively [points, (3.0±1.2) vs (7.8±1.5), P<0.001], regardless no difference between the two groups at 6 months and the last follow-up (P>0.05). There were no statistically significant differences in the AOFAS score, and ROM between the two groups at any other corresponding time points (P>0.05). As for imaging, the B?hler angle, Gissane angle, cartilage surface collapse, calcaneal length, calcaneal width, and calcaneal height in both groups were significantly improved at the last follow-up compared with those preoperatively (P<0.05), whereas which were not statistically significant between the two groups at any time points accordingly (P>0.05). [Conclusion] The percutaneous reduction and fixation technique for subtalar collapse-type (Sanders Ⅱ~Ⅲ type) calcaneal fractures has the advantages of satisfactory reduction, reliable fixation, small trauma and few complications.