Inclusion Criteria:  Rockwood clinical frailty scale (CFS) of 5 or more, or aged 65 years or over; A recent odontoid fracture (type I-III) (within 3 weeks) as assessed on CT, irrespective of degree of fracture angulation, displacement or canal narrowing; History of recent trauma (within 3 weeks) Determined by spinal consultant (or delegated registrar) as suitable for standard care 12-week treatment with hard collar and for randomisation to treatment without a collar Recruited within 3 weeks of injury  Exclusion Criteria:  Fracture sustained in high-impact injury; New neurological deficit (numbness / weakness) attributable to fracture; Assessed as unable to tolerate a hard collar e.g., dystonia, fixed deformity; Additional (non-odontoid) cervical spine fracture not suitable for management without a hard collar; Underlying condition potentially leading to spinal instability, e.g., ankylosing spondylitis, diffuse idiopathic skeletal hyperostosis (DISH); Fracture suspected to be older than three weeks at the time of assessment; Consultant spinal surgeon determines fracture requires surgical treatment or is otherwise unsuitable for non-surgical treatment with or without a hard collar; Fall from more than 6m, patient ejection from vehicle, death in same vehicle, vehicle versus pedestrian (patient), vehicle versus cyclist (patient) If not expected to survive to hospital discharge based on concomitant injuries or illnesses.