Heel fractures are the most common tarsal fracture, accounting for approximately 60% of tarsal injuries and 1% to 2% of systemic fractures. Currently, the lateral extension approach to the heel is the most commonly used incision for the management of heel fractures and is considered to be the standard approach for the surgical treatment of intra-articular heel fractures as it can fully expose the heel fracture and the subtalar joint, allow dissection and repositioning of the posterior articular surface under direct vision, and restore the overall shape of the heel. However, the rate of soft tissue complications, including wound dehiscence, skin necrosis and infection, is as high as 5% to 20%. To avoid these complications, we have used internal fixation through the tarsal sinus incision to treat intra-articular heel fractures without serious incisional complications and with satisfactory results.