Objective To analyze the characteristics of clinical prognosis of calcaneal fracture of Sanders type Ⅲ in different ages and occupations.

Methods A retrospective cohort study design was used to select 110 patients with Sanders type Ⅲ calcaneal fracture who underwent open reduction and internal fixation from January 2016 to December 2018. Age, occupational recovery time, American Society for Foot and Ankle Surgery (AOFAS) ankle-posterior foot score, and secondary subtalar joint fusion surgery were collected and analyzed.

Results Elderly patients with calcaneal fracture had longer time than non-elderly patients (P < 0.05). The recovery time of calcaneus fracture in patients with heavy physical strength occupation was longer than that in patients with light physical strength occupation, and AOFAS ankle-posterior foot score was lower than that in patients with light physical strength occupation (P < 0.05). The effects of age and occupation on the return to work time were positively multiplied (P < 0.05), which indicated that the recovery time of the two factors was much longer than that of presence of the single factor.

Conclusion Elderly patients have longer time to resume work than non-elderly patients. Patients with heavy physical strength occupation have significantly longer recovery time than those with light physical strength occupation, and are more likely to have lower AOFAS ankle-posterior foot score and higher secondary subtalar joint fusion rate. Therefore, for elderly patients with Sanders type Ⅲ calcaneal fracture who are engaged in heavy physical strength occupation and are eager to return to work, primary subspace arthrodesis is helpful to better restore patients'normal life and work.