Comparative evaluation of surgical treatment outcomes in avascular necrosis of the femoral head using individualized metal fixation systems

Background. Avascular necrosis of the femoral head in children is characterized by progressive epiphyseal deformity, persistent pain, and impairment of hip joint function. Optimization of surgical management through the use of advanced diagnostic modalities and personalized fixation strategies remains a clinically relevant objective. Objective. To evaluate the effectiveness of individualized metal fixation systems in the surgical treatment of pediatric avascular necrosis of the femoral head compared with conventional fixation techniques. Materials and Methods. An ambispective cohort study with a historical control was conducted between 2023 and 2025. A total of 150 children aged 4–15 years were included: a retrospective group (n=80) treated with conventional surgical techniques and standard fixation, and a prospective group (n=70) managed using multislice computed tomography (MSCT) with 3D reconstruction, Doppler ultrasound assessment, and individualized fixation constructs.