424 patients with a calcaneal fracture were randomized to operative or nonoperative management. Operative care involved a lateral approach and rigid internal fixation, and nonoperative care was treatment only with ice, elevation, and rest. Patients were assessed between 2 and 8 years with the SF-36 and for pain with the visual analog scale. The two groups did not significantly differ in these outcome measures, though patients managed operatively and not receiving Workers’ Compensation had significantly higher satisfaction scores. Women managed operatively had significantly higher SF-36 scores than women managed nonoperatively.