From 1965 to 1991, 273 patients with crush fractures of cervical vertebrae were treated. They were sustained by young people in diving accidents, road accidents, or falls from a height. Spinal cord involvement with a varied degree of tetraplegia was usually present. The results of management by nonoperative or operative means have been compared There has been neurological improvement in 14% of nonoperative and 44% of operative cases. Early surgical decompression by an anterior approach with stabilization by a bone graft is advocated to improve outcome and reduce the time in hospital.