Objective    To investigate the factors influencing the postoperative complications of internal fixation of the tarsal sinus incision hippocampal plate for Sanders type II and III calcaneal fracture. Methods    A retrospective analysis of 85 patients with Sanders type II and III calcaneal fracture treated with tarsal sinus incision hippocampal plate internal fixation from January 2021 to April 2022 was performed. According to the postoperative complications, they were divided into a complication group and non-complication group. The non-complication group was defined as recovery to baseline function within 6 months after operation, doing normal work and daily activities, and no continuous need for analgesics. The complication group was defined as fracture complication requiring re-hospitalization, the use of a walking aid, and continuous analgesics. The risk factors for complications of Sanders II and III bone fractures were  analyzed by univariate and multifactorial methods.    Results    Multi-factorial logistic regression analysis result showed that time from fracture to surgery, Sander type III, postoperative B?hler angle, and DVBA were as independent risk factors for complications. Age was not associated with the development of postoperative complications.    Conclusions    Clinicians should be alert for postoperative complications in patients with Sander type III, poor postoperative B?hler angle recovery, and long fracture-to-operation time for calcaneal fracture.