Shared Decision Making with a Traumatic Atlas Fracture Woman: A Case Report

高齡女性寰椎骨折的共享決策經驗—病例報告

10.6200/TCMJ.202409_21(3).0009

Yu-Yun Jheng(鄭育昀)；Yun-Chen Ko(柯澐蓁)

shared decision-making (SDM) ； atlas fracture ； conservative treatment ； rigid collar ； patient-centered care ； 醫病共享決策 ； 寰椎骨折 ； 保守治療 ； 硬式頸圈 ； 以病人為中心的醫療

北市醫學雜誌

21卷3期（2024 / 09 / 30）

284 - 292

英文;繁體中文

Shared decision-making (SDM) is a patient-centered approach where medical professionals collaborate with patients to make treatment decisions. In this case report, we describe an 88-year-old woman who suffered a traumatic atlas fracture, and surgical treatment was initially recommended. However, she tended to endorse conservative treatment and consulted her family physician. Her family physician conducted a thorough review of medical literature and explained the risks of surgical and non-surgical treatments. Finally, a rigid collar was decided. Subsequent follow-up of the patient showed no neurological deficits, and she regained neck mobility. This case reveals that conservative treatment with rigid collars is a safe and effective option for stable atlas fractures. Family physicians play a crucial role in consolidating medical information and facilitating SDM, which respects patient's preferences and values, promotes information exchange between medical staff and patients, and makes the best treatment plan together.

醫病共享決策是以病人為中心，醫師與病人合作討論治療決策。我們報告一名88歲創傷性寰椎骨折的女性病人，醫師初步建議手術治療。但她傾向保守治療，尋求家庭醫師意見。家庭醫師全面查閱醫學文獻，解釋手術和非手術治療的風險。最終，決定使用硬式頸圈。後續追蹤顯示病人無神經缺損，頸部運動能力恢復。此案例呈現在經過文獻查證後針對穩定寰椎骨折，硬式頸圈保守治療為安全且有效的選擇。家庭醫師在整合醫學資訊和推動共享決策中扮演關鍵角色，尊重病人偏好和價值觀、促進醫病間的資訊交流，並共同制定最佳治療計劃。

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