One thousand one hundred twenty-eight (1,128) patients aged 60 years and older with trochanteric hip fractures were randomized to receive either the X-Bolt Hip System (XHS) (n=564) or the sliding hip screw (SHS) (n=564). The primary outcome of interest was the EQ-5D-5L utility score at four months post-surgery. Secondary outcomes included EQ-5D-5L at 12 months, mortality, residential status, mobility, revision surgery, and radiological measures. Outcomes were assessed at four and twelve months. Overall, the results showed no statistically significant or clinically meaningful difference in the EQ-5D-5L utility score at four months between the XHS and SHS groups. There were also no significant differences in any secondary outcomes. The findings suggest that XHS does not offer a superior quality of life or safety advantage over SHS.