Objective To investigate the effect of hollow nail internal fixation via tarsal sinus on AOFAS score and complications of calcaneal fracture.Methods A total of 80 patients with calcaneal fractures admitted in our hospital from February 2018 to March 2019 were selected as the research object, and were divided into two groups according to the random number table method, 40 cases in each group.The control group was internally fixed with lateral enlarged incision steel plate, and the observation group was internally fixed with hollow nails of tarsal sinus approach.The postoperative foot function, imaging indexes at 3 months after operation, AOFAS score and complications during the 1 year follow-up were compared between the two groups.Results Three months after operation, the height of calcaneal tubercle and Bohler angle of observation group were larger than that of control group, and the widths of calcaneus were smaller than control group, the differences were statistically significant (P<0.05);3 months after operation and 1 year after operation, the AOFAS scores of the observation group were higher than that of the control group, and the differences were statistically significant (P<0.05);1 year after surgery, the total proportion of incision infection, skin necrosis,osteomyelitis, and sural nerve injury in the observation group was lower than that in the control group, the good rate of foot function evaluation in the observation group was higher than that in the control group, and the differences were statistically significant (P<0.05).Conclusion The tarsal sinus approach with hollow screw internal fixation can effectively promote the anatomical reduction of calcaneus in patients with calcaneal fractures, and promote the recovery of postoperative foot function with less complications and high efficacy.