333 patients with AO/OTA 31-A1 and 31-A2 pertrochanteric stable femur fractures were randomized to be surgically treated via intramedullary fixation with or without distal locking screws. The purpose of this study was to determine if fixation without distal locking demonstrated comparable clinical and perioperative outcomes when compared to fixation with distal locking after 12 months. Fixation without distal locking demonstrated comparable measurements at all clinical outcomes and decreased operation time, incision length, blood loss and residual thigh pain when compared to the locking group, suggesting that distal locking may not be necessary during intramedullary fixation of stable femur fractures.