PURPOSE: To analyze early postoperative complications of calcaneal fractures operated by a lateral extensile approach and to identify risk factors for wound complications. MATERIALS AND METHODS: From July 1990 to February 2003, 116 calcaneal fractures in 104 patients were treated by open reduction and internal fixation through a lateral extensile approach. The patient's records were reviewed for early postoperative complications. Statistical analysis was performed to determine significant relationships between predicted variables and the development of wound complications. RESULTS: Fourteen fractures (12.0%) developed infection. Ten of them were superficial infection and four were deep infection that required surgical treatment. Eight fractures (6.9%) developed skin necrosis. Six of them were marginal skin necrosis and two were flap necrosis that required surgical treatment. Seven fractures (6.0%) developed sural nerve injury, but their symptoms were improved without additional treatment. Open fracture (p=0.003) and prolonged operating time (p=0.049) increased significantly the rate of wound complications. CONCLUSION: The rate of early postoperative complications of calcaneal fractures operated by a lateral extensile approach is high. These complications can be reduced by meticulous treatment of an open wound, reduced operating time within 90 minutes through preoperative planning and skillful technique, and correct incision to avoid damage of the sural nerve.