The United States Virgin Islands (commonly called the U. S. Virgin Islands or USVI) are a group of islands in the Caribbean that are an insular territory of the United States of America (commonly called US). The U. S. Virgin Islands has all the beauty of the Caribbean with all of the conveniences of the US.he total land area of the territory is 133.73 square miles (346.4 km2). Most of the islands, including St. Thomas, are volcanic in origin and hilly. St. Croix, the largest of the U. S. Virgin Islands, lies to the south and has a flatter terrain.
Malignant pathologic fractures may present in the following three ways: 1  Fractures through a primary malignant bone tumor. 2  Fractures through solitary metastatic lesions without a known primary site of disease. 3  Fractures through metastatic disease in patients with a known primary cancer diagnosis.
This patient has spiral distal tibia and proximal fibula fractures. Dedicated imaging of the ankle should be performed to exclude a posterior malleolus fracture. Imaging options include either dedicated ankle radiographs or CT scans. Tibial shaft fractures arise from high- or low-energy injuries. Low-energy injuries are characterized by (1) torsional mechanism of injury, (2) spiral pattern, (3) fibula fracture at a different level. Surgical options for closed shaft fractures include IM nailing and plate fixation.