Case Report
A 43-year-old woman with VACTERL sustained a Vancouver B1 periprosthetic femur fracture (PFF) following right revision total hip arthroplasty with a cemented femoral component. She underwent open reduction and internal fixation (ORIF) with dual plate fixation, and later received abaloparatide and autologous bone grafting with iliac crest aspirate at 10 months post-ORIF. The fracture achieved radiographic union 2 years post-ORIF./r/nPFFs in patients with metabolic bone disease may require prolonged healing. Use of dual-implant fixation and a multidisciplinary approach to treat underlying metabolic bone disorders can help overcome delayed healing in these cases.