To investigate the operative treatment of displaced intra-articular calcaneal fractures (DIACFs) using a combination of small lateral incision approach and internal fixation and allograft bone transplantation. Methods From January 2005 to December 2007, 28 patients with 34 DIACFs were treated with open reduction, allograft bone transplantationand internal fixation through a small lateral incision approach. Of them, there were 18 males and 10 females, aged 16-65 years. The disease course was 2 hours to 18 days. According to Sanders classification, there were 18 cases of type II fractures, 10 cases of type III fractures and 6 cases of type IV fractures. Results 22 patients with 28 DIACFs were followed up 18.5 months (13-28 months). The wound of 26 feet achieved primary heal ing, the acute rejection was found in 2 patients and developed wound compl ications. Both patients underwent further surgery prior wound heal ing. After the internal fixation were removed, factures was fixed with external fixator, closed continuous irrigation and drainage was employed. In the meantime, both patients received antibiotics and incisional dressing change. As a result, one achieved primary heal ing, the other developed delayed heal ing. Thepreoperative X-ray film showed that Bouml;hler angle was (6.19 ± 9.66)° and Gissane angle was (103.04 ± 15.03)°; the postoperative X-ray film demonstrated that Bouml;hler angle was (34.51 ± 5.89)° and Gissane angle was (112.18 ± 10.50)°; showing statistically significant differences (P lt; 0.05). The internal fixation of 12 patients (14 DIACFs) were removed at 6 -10 months after operation, Bouml;hler angle was (32.81 ± 5.10)° and Gissane angle was (110.81 ± 9.98)°. When compared with preoperative X-ray film, statistically significantdifferences (P lt; 0.05) was found, but there was no statistically significant differences (P gt; 0.05) when compared with normal X-ray film. According to the American Orthopedic Foot and Ankle Society evaluation system for ankle-hind foot, 3 feet scored 60-70 points, 10 feet 70-80 points, 12 feet 80-90 points and 3 feet 90-100 points. Conclusion Allograft bone transplantation is an option for management of DIACFs, because it enables satisfactory reconstruction of bone defects, allows met anatomic reduction and functional recovery, maintaining restoration of calcaneal height and anatomic reduction of the posterior facet.