Aims: The goal of this study to compare the clinical outcome of patients with calcaneus fractures differential strategy and non-differential conservative strategy treated. Methods: The study based on the results of treatment of 122 patients with 140 heel bone fractures. Results of only conservative treated 52 patients (54 fractures) in period 1992–1999 were retrospectively evaluated. Results of 70 patients (86 fractures) differential strategy treated in period 1999–2001 were prospectively evaluated. The plain radiographs – that is lateral, antero-posterior, oblique radiographs of the foot, axial and Broden view – and computerized tomography were used for examine patients. In period 1999–2001 the patients were differential strategy treated. All patients were divided in 5 groups: non-displacement fractures (early range of motion), beak type fractures (close reduction internal fixation by cannulated screw), tongue-type fractures (axial reposition axial fixation by Schantz screw), jointdepression and comminuted fractures (ORIF calcaneus bone plate AO). The results were evaluated by own score system in first group in 4 – 8 years period and 1 – 2,5 years period in second group. Results: The results of differential strategy treated patients with heel bone fractures (excellent – 60,9%± 5,9, good – 29,0%± 4,8, fair – 5,8%± 2,4, bad – 4,3%± 2,1) were reliably (p≥95%) better than results in only conservative treated group (excellent – 26,8%±4,7, good – 23,9%±4,5, fair – 23,9%±4,5, bad 25,4%±4,6). Conclusions: This study demonstrates that the differential strategy of treatment allows to reach good results and minimize soft tissue trauma.