204 patients were randomly allocated to undergo either extramedullary device (DHS) or intramedullary (IM) nail fixation for an intertrochanteric fracture of the femur. 12 month results aimed to compare the radiological and clinical outcomes of both procedures. At the end of the study period, no significant differences were seen in lower extremity measure (LEM), functional independence measure (FIM), the Timed Up & Go (TUG), 2 minute timed walk, Trendelenburg test or tip-apex distance (TAD). IM nail had less femoral neck shortening, but greater Brooker stage 1 heterotopic ossification.