Objective To investigate the effect of self- designed calcaneal column screw guide device in the treatment of calcaneal fracture sinus tarsi approach. Methods A retrospective analysis of 65 patients with Sanders II and III calcaneal fractures from August 2014 to February 2018 was conducted. The patients were divided into guide group(group A) and non-guide group(group B) according to whether they used self-designed calcaneus column screw guides. Intraoperative pin adjustment times, the number of intraoperative fluoroscopy, operative time, number of error cases of column screw position，fracture healing time, calcaneus B?hler angle and Gissane angle at the last follow-up, visual analogue scale (VAS), and AOFAS ankle hindfoot scores were compared between the two groups. And record related complications. Results Patients in the two groups were followed up for 12-36 months after surgery, group A and the group B were (18.49±2.55) months and (20.07±3.72) months, respectively.Intraoperative pin adjustment times[1(0,1)times], the number of intraoperative fluoroscopy[4(4,5)times] ,operative time [68.00±11.13mins] , and number of error cases of column screw position［0］in group A. The number of intraoperative pin adjustments [2(1.75,3)times], the number of intraoperative fluoroscopy [7(6,8)times], operative time [79.83±9.14mins], and number of error cases of column screw position［5］in group B , the differences between the above two groups were statistically significant(P < 0.05). Fracture healing time in the guide group and the non-guide group [12 (12, 12) weeks and 12 (12, 12) weeks], B?hler angle at the last follow-up [(27.83 ± 3.53) ° and (26.17 ± 3.29) °], Gissane angle [( 112.14±7.79)° and (111.67±8.02)°], VAS scores [1 (1, 2) and 1 (0.75, 2)], AOFAS scores [85 (79, 97) and 85 (72, 97)], the differences between the two groups were not statistically significant (P>0.05). Conclusion Percutaneous fixation with a self-designed calcaneus column screw guide improves the efficiency of screw placement, reduce intraoperative fluoroscopy times, reduce the number of intraoperative fluoroscopy, and shortens the operation time.