Objective: To evaluate the preventive effect of internal fixation of keel locking plate for the loss of joint reduction in intra-articular calcaneal fractures patients with osteoporosis. Methods: 86 intra-articular calcaneal fractures patients with osteoporosis were randomly divided into observation group and control group, with 43 cases in each group. The observation group received internal fixation of keel locking plate,the control group received internal fixation of anatomical plate.The perioperative related indicators,scores of American Orthopaedic Foot & Ankle Society(AOFAS) at 12 months after operation and the excellent rate of ankle function between the two groups were compared,the B hler angle, Gissane angle,calcaneus width, calcaneus heightbefore operation and 1 week, 6 months, 12 months after operation and its degree loss were evaluated. Results: There were no significant differences in the incision length, operation time, intraoperative blood loss and postoperative hospital stay between the two groups(P>0.05),the healing time of the fractures in the observation group was significantly shorter than that in the control group(P<0.05);At the last follow-up, the loss of B hler angle, Gissane angle, calcaneal width and calcaneus height in the observation group were significantly lower than in that the control group(P<0.05);The AOFAS score and excellent rate of ankle function in the observation group were significantly higher than those in the control group(P<0.05). Conclusion: The internal fixation of calcaneal locking plate is effective in the treatment of intra-articular calcaneal fractures patients with osteoporosis,which can reduce the loss of joint reduction compared with anatomical plate.