82 patients with intra-articular calcaneal fractures of > 2mm displacement (verified by computed tomography scans) were randomly assigned into operative or non-operative groups, to compare the effectiveness of each treatment. The results demonstrated that there were no significant differences between the two groups at the one year follow up in terms of pain (VAS), or physical/mental functioning (SF-36). There was however, a trend observed at the eight-twelve year follow-up in VAS pain and function scores, and physical SF-36 scores, in favour of the operative group. The study also indicated that while operative treatment lead to a higher risk of complications, it also resulted in significantly reduced risk of subtalar arthritis.