title: The definition of recurrent shoulder dislocation in tramadol induced seizure patients.
abstract: BACKGROUND
  Prevalence of recurrent shoulder dislocation in patients taking tramadol has not been studied yet; so, this study aims to study the recurrent shoulder dislocation following tramadol induced seizure.
  
  
  METHODS
  In this cross-sectional study, 205 patients with recurrent shoulder dislocation complaints (2 or more) referred to Shafa Orthopedic and Iranmehr hospitals Tehran, Iran, from October 2012 to October 2014 were studied. Data on patient history and physical examination, patient demographic information such as age, sex, age at first dislocation, total number of dislocation, cause of the first dislocation, history of tramadol use, number of dislocation following tramadol induced seizure, history of other drugs use, the dominant hand, involved side, direction of dislocations and greater tuberosity fracture was recorded using a pre-designed questionnaire. Categorical variables were compared by chi-square test and the means were compared with student T-test.
  
  
  RESULTS
  In this study, 50 patients (24.4%) suffered from tramadol induced seizures and recurrent shoulder dislocation. RESULTS showed that there was a significant relationship between the number of dislocation and tramadol use (P = 0.02). Recurrent shoulder dislocation following tramadol induced seizure was significantly associated with greater tuberosity fracture of humerus (P = 0.04); in 49 out of 50 patients (98%) dislocation was of anterior type.
  
  
  CONCLUSIONS
  The findings of this study suggest that tramadol induced seizure may increase the risk of recurrent shoulder dislocation. Furthermore, the prevalence of greater tuberosity fracture in shoulder dislocation increases following tramadol induced seizure; and anterior shoulder dislocation is the most common type of dislocation following tramadol induced seizure.
authors.affiliation: Assistant Professor, Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran. nakhaei.m@iums.ac.ir.
authors.forename: Morteza
authors.initials: M
authors.lastname: Nakhaei Amroodi
authors.affiliation: Orthopedic Resident, Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran. dr.iri59@yahoo.com.
authors.forename: Abdolrazzagh
authors.initials: A
authors.lastname: Iri
authors.affiliation: Resident of Anesthesiology, Anesthesiology department, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran. Salehe.Akhoondi@gmail.com.
authors.forename: Salehe
authors.initials: S
authors.lastname: Akhoondi
keywords: Recurrent shoulder dislocation; Seizure; Tramadol