Objective To investigate the treatment of femoral neck fractures in children with vascularized periosteal bone flaps and to evaluate their efficacy. Methods A total of 14 cases and 14 hips were treated from June 2003 to March 2014; ages ranged from 9 to 18 years, with a mean of (14.7±2.8) years; 10 cases were male and 4 cases were female. There were 9 old fractures of the femoral neck (and 5 cases of femoral head necrosis), 4 fresh fractures of the femoral neck, and 1 case of slipped femoral epiphysis. garden typing: 7 cases of type III and 7 cases of type IV. The surgery was performed with internal fixation by incision and hollow nail, and then treated by iliac flap graft with rotated deep iliac vessels in 8 cases and partial treatment with broad fascial tensor fasciae periosteal flap in 6 cases. Results All 14 surgeries were successful, and the follow-up time ranged from 4 months to 129 months, with a mean of 47.8 months; 14 patients had X-ray suggestive of femoral neck fracture healing, and 5 patients with femoral head necrosis had femoral head repair. Evaluation by Ratliff criteria: excellent in 8 cases (57.1%), good in 5 cases (35.7%), and poor in 1 case (7.2%), with an excellent rate of 92.8%. Conclusion Periosteal bone flap with blood vessels is an effective and good method for treating femoral neck fracture and femoral head necrosis in children; partial periosteal flap graft with broad fascial tensor fasciae for treating femoral neck fracture and femoral head necrosis in children has not been reported in the literature, which is a new procedure with little injury and especially suitable for children.