This study examines the premise that follow-up after fifth metacarpal neck fractures is unnecessary after initial assessment in a hand clinic. Forty consecutive patients with this fracture were managed in plaster and followed up. The next 38 patients were treated with neighbour strapping, given information sheets and no follow-up visits were arranged. In the first group, most return visits were for removal of plaster. Almost half of the appointments, thereafter, were not attended. In the second group, only two patients returned to the clinic, one with minor complaints and one with a repeat injury. Patients reported better satisfaction when managed with neighbour strapping (P=0.04) and without regular follow-up visits (P<0.01). The time to return to work was a mean of 5 weeks and 2.7 weeks in the first and second groups, respectively (P<0.01). There was no significant difference in the functional outcome at 12 weeks, as assessed by the DASH score.