Thirty-two patients with acute calcaneal fractures presented to the Veterans Affairs Medical Center, Miami, Florida, from October 1985 through March 1994. Twenty-three of these patients were open-reduced, and nine were immobilized in a short leg nonweight-bearing cast for a minimum period of 6 weeks. Of the 23 patients who had open reduction with internal fixation, 74% reported excellent results, 13% reported good results, 4% had fair results, and 9% had poor results. Of the nine patients who did not undergo open-reduction internal fixation, three subsequently developed poor results, two developed fair results, three developed good results, and one had no complaints. Of these nine patients, three ultimately underwent successful hindfoot arthrodesis. This article reviews the current literature and discusses the experiences of the Podiatry Service in the VA Medical Center in Miami, Florida, with respect to the surgical management of the acute calcaneal joint depression fracture.