From this study it has been found that the severe, comminuted, displaced calcaneal fracture is associated with involvement of the two peritalar joints consisting of fracture of the articular surface of the calcaneus at the calcaneo-cuboid joint and, in some instances, associated subluxation of the talar head at the talonavicular joint. The conventional projections are not adequate for the roentgenographic examination of the comminuted, displaced, fractured calcaneus, and two additional projections as described are necessary. Involvement of the two peritalar joints affords an explanation for some of the unsatisfactory results reported in the past. We believe that the injury to the talocalcaneal joint is irreparable and that fusion of this weight-bearing joint is necessary. The associated injuries of the two peritalar joints similarly prevent the restoration of their normal function. It has been our experience that triple arthrodesis as the initial primary treatment of these fractures has given extremely gratifying results.