INTRODUCTION: The olecranon approach has been the gold standard for surgical approaches to fracture fixation of distal articular surface of humerus. Although it provides a good exposure, it also has disadvantages of delayed union, nonunion and implant related complications at the osteotomy site. OBJECTIVE: The aim of this study was to determine the functional outcome of displaced intra-articular distal humerus fracture fixation using an alternative approach: the Bryan and Morrey approach. MATERIALS AND METHODS: Twenty patients with twenty AO type C1 and C2 intercondylar fractures of the distal humerus had bicolumnar fixationof the distal humerus with two contoured reconstruction plates and screws on the dorsal surface or various combinations of a single reconstruction plate, screws and K-wires using a Bryan and Morrey approach. Twelve of the patients were male and eight were female. The average age of the patients was 44.8 years. Eleven patients had sustained the injury as result of fall and nine of the patients had sustained it in road traffic accidents. Right elbow was involved in fifteen patients and left in five. All patients were followed up for 12 months post operatively. RESULTS: All twenty fractures had united at 4 months follow-up. The mean fixed flexion deformity was 9.0º (range 0º-15º) and the mean arc of motion was 115.0 º (range 85 º- 130º). All patients had grade 4 triceps strength and stable elbows at the end of 12 months follow up. One patient had deep seated wound infection resulting in necrosis of the triceps tendon requiring a second operative procedure. CONCLUSIONS: Bryan and Morrey approach is a simpler, easier and better approach as compared to the other posterior approaches to the elbow joint, and therefore, can be used as the approach of choice for fixation of fractures of the distal articular surface of humerus. KEYWORDS: fracture, Humerus, intercondylar, osteosynthesis.

Introduction: Ocular morbidities are importantbecause of their impact on child’s development,education and future work. Ocular morbidities in children may not be diagnosed and treated in time due to inability to express their problems which leads to amblyopia by the time they can express it. This study was conducted with an objective to determine the pattern of ocular morbidity in children less than and equal to 14 years of age presenting in the Outpatient Department (OPD) of Gandaki Medical College, Pokhara. Materials/ Methods: This is a cross sectional observational study where we reviewed the profile of all of all patients of age group equal to or less than 14 years entering eye OPD from September 2016 to September 2018 for eye examination. Result: A total of 1471 patients presented to eye department of GMC. The mean age of the patient was 8.25 ±4.24 years among which 57.8% were males and 42.2% were females. Maximum number of the patients were in age group 11 to 14 years (38.1%) while minimum number of the patients were in the age group <1 year(10.6%).Conjunctival disorders (23.9%) was the most common ocular morbidity followed by refractive error in (18.2%), miscellaneous conditions (10.4%), eyelid diseases (8.6%), lacrimal system diseases (7.8%). Conclusion: Thestudy gives a picture and pattern of ocular diseases in pediatrics age group which not only helps in early diagnosis and treatment of ocular diseases but also in decreasing the magnitude of childhood blindness and amblyopia.

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