Background; This case report is about a female patient (35 years old) from rural KP who was referred to a surgeon with elbow fracture. The most common elbow joint fractures are humeral distal end fractures and radial head fractures. Supracondylar fractures are more common in children than in the adult population around the world. Supracondylar fractures can cause a variety of complications, including mal-union, which frequently results in gunstock deformity. The primary goal of this case report was to investigate: a) the specific activity-based complications associated with the gunstock deformity; and b) the causes of the gunstock deformity. b) the potential chances of the iatrogenic nerve injury with the use of MUA (mobilization under anesthesia) c) designs & conditions-specific long term -rehab programs for these patients. Case Description; A 35-year-old rural female patient was referred to the physiotherapy department of Swat Institute of Medical Science & Research center (SIMS) in Swat. The clinical findings at the baseline examination and assessment of the patient revealed numbness and tingling sensations in the little and half of the ring fingers on the involved side (left) with significant limitation of elbow movements. The patient underwent in SIMS for ulnar nerve transposition surgery, which was followed by a 6-month rehabilitation programme in which electrotherapeutic agents were used for pain relief, elbow flexor and extensor strengthening, and passive elbow mobilization. Outcome;The long-term rehabilitation programme for the gunstock deformity caused by ulnar neuropathy after ulnar transposition surgery was found to be significantly clinically beneficial. The neuropathic signs and symptoms improved, while the elbow range of motion increased significantly. Discussion; The distal end of the humerus- most frequent bone fracture complications are: a) mal-union; b) ischemic contracture; and c) nerve injury. Iatrogenic nerve injuries have been reported in the literature in percentages ranging from 2 to 6. Iatrogenic nerve injuries result from closed manipulations or percutaneous fixations of bone fragments, or they can happen during open surgery to treat the fractures. Tenting or entrapment of the nerve on the sharp proximal nerve fragment causes nerve injuries after supracondylar humeral fractures.

Elbow fractures, Gun stock deformity, Ulnar neuritis