165 patients with low-energy intertrochanteric fractures were randomized to receive treatment using the extramedullary sliding hip screw or the dual lag screw cephalomedullary nail. Over a mean follow up of 36 months, there were no differences between the two groups for functional recovery, intra-operative outcomes, length of hospital stay, delay to surgery, re-operation rate, mortality, complication rate, and implant positioning. The cephalomedullary nail group had a significantly shorter mean operation time, but a longer fluoroscopy time than the sliding hip screw group. In three cases in the cephalomedullary nail group the proximal screws displaced (Z effect).