Seventy-six patients with unstable intertrochanteric femur fractures were randomized to Proximal Femoral Nailing (PFN) (n=38) or Proximal Femoral Nailing Antirotation 2 (PFNA2) (n=38). The primary outcome of interest was function (Harris Hip Score). Secondary outcomes included operation time, intraoperative blood loss, fracture union (rate/time), radiological healing (RUSH score), weight-bearing/recovery status, and complications. Outcomes were assessed at 1, 3, and 6 months. Overall, the results revealed PFNA2 reduced operation time and blood loss versus PFN, while functional scores (HHS), union, RUSH, weight-bearing, and complications were not different between groups. In short, PFNA2 offers peri-operative efficiencies without demonstrable superiority in clinical or radiographic outcomes by 6 months.