The use of a "reverse" axis (axillary-interscalene) block in a patient presenting with fractures of the left shoulder and elbow.

IMPLICATIONS: A patient presented for surgery to repair a fractured left shoulder and elbow and requested regional anesthesia. Most upper extremity operations require a single brachial plexus nerve block. The position of the two fractures however required the use of two separate approaches, an interscalene and an axillary approach.