60 high-risk elderly patients with an intertrochanteric fracture were randomized to receive fixation with either a dynamic hip screw or an external fixator, to compare clinical and functional outcome, in addition to length of operation and hospital stay. Results revealed that intraoperative time and hospital stay length were both significantly shorter with an external fixator. Additionally, significantly fewer patients required blood transfusions with external fixator versus dynamic hip screw. Proportion of acceptable reductions, mean VAS pain scores, mean Harris hip scores, and complication rates were similar between groups.