University of Iowa Hospital records from 1926 to 1988 were searched for cases of hip fractures in otherwise healthy children aged between 1 and 16 years. Twenty-six cases were identified. Nineteen patients were available for clinical and radiographic follow-up evaluation. The average follow-up was 16 years postinjury. There were four type I (transepiphyseal), nine type II (transcervical), three type III (cervicotrochanteric), and three type IV (intertrochanteric) femoral fractures. Avascular necrosis (AVN) of the femoral head complicated nine of the 19 fractures (47%). Seventy-eight percent of patients who developed AVN required additional surgical intervention to obtain acceptable hip function.