68 patients with a fifth metacarpal neck fracture were randomized to two different conservative management options: buddy taping with soft wrapping, or closed reduction and cast immobilization. The purpose of this study was to compare clinical and radiological outcomes between the two treatment options. Follow-up was conducted over 4 months post-injury. No significant differences were observed in clinical and radiological outcomes between groups. The group which received buddy taping with soft wrapping experienced fewer days lost from work compared to the group which received reduction and cast immobilization.