Objective       To evaluate the clinical efficiency of vascularized iliac periosteal bone-flaps graft accompanied by internal fixation in treating old fractures of femoral neck in children.        Methods       From May 2009 to April 2013

a total of 9 children (5 with the avascular necrosis of femoral head) suffering from old fractures of femoral neck were enrolled in this study. There were 6 boys and 3 girls. The mean age was 13.7 years (ranging from 9 to 18 years). According to Garden classification

4 hips were identified as type Ⅲ and 5 as type Ⅳ. Iliac periosteal bone-flaps graft with deep circumflex iliac vessel was performed in 4 patients and iliac periosteal bone-flaps graft with partial tensor fasciae lata in 5.        Results       All patients were followed up over a mean period of 40.8 months (ranging from 11 to 94 months). All the fractures were healed. According to Ratliff evaluation criteria

4 patients were assessed as excellent and 5 as good.        Conclusion       The vascularized iliac periosteal bone-flaps graft accompanied by internal fixation is an effective method to treat old fractures of femoral neck in children. Iliac periosteal bone-flaps graft with partial tensor fasciae lata is a new and effective procedure with small trauma to treat fractures of femoral neck and avascular necrosis of femoral head in children.