198 patients over the age of 65 with unstable trochanteric fractures were randomized to fixation with either a proximal femoral nail antirotation (PFNA) or dynamic hip screw (DHS). The purpose of the study was to compare the outcomes of these methods up to 6 months after surgery. The PFNA group was associated with a significantly shorter operative and fluoroscopy time, shorter hospital stay, and lower blood loss compared compared to the DHS group. Complication rates, tip-apex distance, screw cutout incidence and recovery of walking ability were similar between groups.