We conducted a randomised prospective comparison of the Compression Hip Screw(CHS) and gamma nail for internal fixation of 60 intertrochanteric femoral fractures in elderly patients. The gamma nail group showed shorter convalescence and earlier full weight-bearing. There were however no significant differences in the operative time, blood loss, stay in hospital' and patien's mobility at the final review. Intra-operative lateral cortex fracture and post-operative cutting cut were recorded in the gamma nail group. Use of the gamma nail is thus not recommended for these complications considering the good results of CHS.