Objective To observe the clinical effect of internal fixation of Sanders type Ⅲ calcaneus fracture with cannulated screw and mini plate through tarsal sinus incision. Methods From January 2016 to December 2018, 62 patients (71 feet) with Sanders type Ⅱ and III calcaneal fractures were randomly divided into the observation group (34 cases / 38 feet) and the control group (27 cases / 33 feet) ,treated through lateral incision and tarsal sinus incision. The operation time, hospitalization time, visual analogue score, complications, calcaneus imaging parameters, Maryland score and AOFAS score were observed in the two groups. Results ① The difference of hospitalization time and VAS score between the observation group and the control group was statistically significant (P < 0.05).② The rate of incision healing and other complications in the observation group was significantly lower than that in the control group (P < 0.05).③ There was no significant difference in width, length, Gisanes angle and Bohlers angle between the two groups (P > 0.05). ④Maryland score and AOFAS score in the observation group were significantly better than those in the control group at 1 and 3 months postoperatively (P < 0.05), and there was no significant difference between the two groups at 6 months postoperatively (P > 0.05). Conclusion The treatment of Sanders Ⅲ calcaneal fracture by microsurgical anatomical plate combined with multiple hollow nails through tarsal sinus incision could shorten the hospitalization time and reduce the complications, but the exposure scope of the incision is limited, which is not conducive to judge the reduction quality of the fractures ,we should be familiar with the fractures displacement rule and master the reduction technology.