One hundred and thirty-three fractures of the fifth metacarpal were reviewed in patients attending a city compensation clinic. Splinting of the hand in a functional position for ten days (except in cases of displaced mid-shaft fractures) followed by mobilization and early use of the hand has proved to be a method of treatment that leads to early return to active duty with a full functional hand. The majority of the fractures involved the metacarpal head and neck and were considered stable impacted fractures. Angulation of up to 40 degrees was accepted without reduction and if easy reduction under local anesthesia was not obtained, angulation of up to 70 degrees was accepted, provided there was not excessive rotation of the distal fragment. This angulation is reflected in mild clinical deformity and has proved not to interfere with normal use of the hand, nor has it resulted in patient dissatisfaction. The complications that result from more exacting methods of treatment are briefly reviewed.