5 randomized controlled trials (RCTs), with a total of 215 patients, were included in this systematic review to determine if there are benefits to reduction and splint or cast immobilization to fractures of the fifth metacarpal neck (or more commonly known as boxer's fractures). Analysis of the included studies indicated that splint or cast immobilization yields no benefits in range of motion, strength, or any other measured outcomes when compared to soft wrap or buddy taping treatment without reduction. On the contrary, majority of trials favoured soft wrap intervention for range of motion and strength improvements compared to splint or cast immobilization.