Introduction: Intra-articular calcaneal fractures are among the most complex orthopaedic injuries. The optimal treatment—conservative or surgical—remains debated due to variable outcomes and complication profiles.

Aim of The Study: To compare the functional and radiological outcomes of conservative treatment versus closed reduction and internal fixation (CRIF) using cannulated cancellous (CC) screws in displaced intra-articular calcaneal fractures.

Materials and Methods: Thirty patients with intra articular fractures, were prospectively studied. Group A (n=15) received conservative treatment; Group B (n=15) underwent CRIF with CC screws. Patients were evaluated over 1 year using the American Orthopaedic Foot & Ankle Society (AOFAS) score, Bohler’s angle, and complication rate.

Results: Group B had significantly better AOFAS score, improved radiological restoration of Bohler’s angle, and earlier return to weight-bearing and occupation. Group B showed a 10% rate of minor wound complications; Group A had higher incidences of malunion and chronic pain.