One hundred patients with intra-articular fractures of the calcaneus scheduled for an open reduction and internal fixation procedure were randomized to receive 3D or 2D fluoroscopy during operation to assess anatomical reduction and implant positions; 2D fluoroscopy was available throughout the operation in all patients. The primary outcome of interest was the incidence of revision surgery. Secondary outcomes of interest included the incidence of complications, number of corrections prior to wound closure, Foot and Ankle Outcome Scores (FAOS), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, and the Short Form 36 (SF-36) quality of life questionnaire. The progression of post-traumatic arthritis was measured with the Kellgren Lawrence Classification system. Total fluoroscopy time and radiation exposure was measured. No significant differences were observed between the 3D and 2D groups for all outcomes.