1000 patients with an AO type A1-3 trochanteric fracture were randomized to fixation with either an intramedullary nail or a sliding hip screw. Patients were assessed for postoperative pain, mobility, and the incidence of complications over 1-year follow-up, as well as surgical outcomes during the perioperative stay. Subgroup analyses were performed for outcomes based on fracture type. No significant differences between IMN and SHS devices were found in either primary analyses or subgroup analyses when compared for the rates of implant cutout, device failure, nonunion, superficial infection, and deep infection. The only significant difference observed for clinical measures was lower pain among patients with an AO type 3 fracture treated with an IMN versus a SHS. No significant difference in mobility scores were noted between IMN and SHS groups.