Radiographs of hip fractures were digitally altered to mask surgeons to the type of implant without compromising the reliability of quality ratings or making the rating process more difficult

Three techniques of blinding radiographs of femoral neck fractures successfully mask surgeons to the type of implant fixated, do not compromise reliability of reduction ratings, and do not make rating most radiographs more difficult. Trialists should explore creative approaches to optimize blinding when designing trials, and should incorporate rigorous approaches to testing blinding success.