70 patients with pertrochanteric fractures underwent intramedullary nailing either with or without distal locking screws. The patient follow-up period was one year where the Harris hip score, fracture union time, femur shortening, recovery of walking ability to pre-injury status (incidence), percentage of patients who required a walking aid, percentage of patients who required a wheelchair, and mortality (percentage) were assessed. There were no significant differences between the treatment and control groups for any of the clinical or radiographic outcomes measured. However, perioperative outcomes, such as operative time, fluoroscopy time, incision length, and blood loss, demonstrated significant advantages in the group without distal locking compared to the group with distal locking screws.