Objective: This study aims to compare the efficacy and outcomes of closed cannulated screw fixation versus open plate fixation specifically in the treatment of Sanders II, III calcaneal fractures in fitness enthusiasts and athletes. Methods: A comprehensive search for randomized controlled studies was conducted using PubMed, Embase, and the Cochrane library, spanning from the inception of these databases to September 2022. Studies were screened based on defined inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.3 software. Results: The analysis included 10 studies, totaling 1014 affected feet in 1010 cases, with 508 feet in 506 cases in the closed group (experimental group) and 506 feet in 504 cases in the open group (control group). The meta-analysis revealed that the closed group had a shorter time to operation and operation time compared to the open group. Additionally, the closed group showed a greater Gissane angle and higher calcaneus, along with fewer postoperative complications. No significant differences were found between the groups in terms of postoperative Bohler Angle, calcaneus width, and AOFAS scores. Conclusions: For fitness enthusiasts and athletes suffering from Sanders II, III calcaneal fractures, closed cannulated screw fixation appears to be superior to open plate fixation, offering benefits such as shorter operation time and fewer postoperative complications. Both surgical methods were comparable in restoring ankle function. This study underscores the importance of selecting appropriate surgical techniques for this specific active population, considering their unique needs and recovery goals.