Abstract: Objective  To investigate the effect of manipulative reduction and internal fixation with small incision for tarsal sinus on inflammation and bone metabolism in patients with calcaneal fractures. 
Methods   Sixty patients with calcaneal fractures admitted to Chengdu Xinhua hospital were selected as observation objects, and were divided into 32 cases in the research group and 28 cases in the control group according to the treatment method. The study group was treated with manipulative reduction and internal fixation through small incision of tarsal sinus, while the control group was treated with steel plate internal fixation through l-shaped incision of lateral calcaneus. The Bohler angle, gissane angle, calcaneal width, curative effect, complications, levels of inflammatory cytokines interleukin-1β（IL-1β）, IL-6, IL-22, osteocalcin(OC), bone alkaline phosphatase(BALP) and N-terminal propeptide of type Ⅰ procollagen were compared between the two groups The levels of type Ⅰ precollagen(PINP), type Ⅰ collagen cross linked telopeptide(CTX), tartrate resistant acid phosphatase(TRAP) and pyridinoline(PYD) were measured. 
Results  after surgery, Bohler Angle and Gissane Angle were significantly larger than those of the control group, and calcaneal width was significantly smaller than that of the control group(P＜0.05). The excellent and good rate of the study group was 93.75%, which was significantly higher than that of the control group(71.43%, P＜0.05). The levels of inflammatory cytokines IL-1 beta, IL-6 and IL-22 in the study group were significantly lower than those in the control group(P＜0.05). The levels of OC, BALP and PINP in the study group were significantly higher than those in the control group(P＜0.05), and the levels of CTX, TRAP and PYD were significantly lower than those in the control group(P＜0.05). The total incidence of postoperative complications in the study group was 9.38%, which was significantly lower than that in the control group(P＜0.05). 
Conclusion  The reduction and internal fixation of small incision for tarsal sinus has a definite effect on calcaneal fractures, which can effectively restore the anatomical structure of the calcaneus and improve bone metabolism, with a small inflammatory stress response and fewer complications. Therefore, it can be popularized.

Key words: fractures, bone, trasal bones, internal fixators