Abstract:[Objective] To introduce the surgical technique and clinical of two stage treatment with Ilizarov external fixator on calcaneal fracture malunion. [Methods] From October 2014 to June 2019, 18 patients with severe calcaneal fracture malunions (Stephers-Sanders III type with calcaneal nodule upward movement) were treated. The age of the patients ranged from 29 to 65 years, with an average of 47.56 years. One-stage vertical incision of the lateral heel was taken to remove the lateral expansive calcaneal wall. After calcaneal osteotomy, Ilizarov external fixator was fixed to gradually extend the calcaneus to restore the height and length of the calcaneus. Subtalar arthrodesis was performed in the second stage. The ankle and hind foot scoring system of the American Association of Ankle Surgery (AOFAS) was used for evaluation. [Results] The average follow-up time was 22.17 months. After operation, calcaneal height was restored and calcaneal varus was corrected in all patients. The subtalar joints were fused in one stage. The height, width, Bohler and Gissane angle of calcaneus were obviously restored without incision complications. The average AOFAS score was 81.17, excellent in 2 cases, good in 13 cases, general in 2 case and poor in 1 case. The excellent and good rate was 83.33%. [Conclusion] This method has the advantages of short operation time, simple operation, less safety complications and good curative effect.