Study objective: We compare buddy taping with plaster casting for uncomplicated fifth metacarpal (boxer's) fractures. We hypothesize buddy taping will give superior functional outcomes at 12 weeks, defined as a 10-point difference on the Shortened Disabilities of the Arm, Shoulder and Hand (quickDASH) score. Methods: This randomized controlled trial included patients aged 18 to 70 years, with uncomplicated boxer's fractures in 2 hospitals in Queensland, Australia. The intervention consisted of buddy taping of the ring and little fingers on the affected side, in which the control group received plaster casting. Primary outcome was hand function as measured by quickDASH score (0 to 100, with 0 indicating no disability) at 12 weeks. Secondary outcomes measured at 3, 6, and 12 weeks included time off work and activities, pain, satisfaction, and the EuroQol 5-Dimension 3-Level score (measure of overall health). Results: Ninety-seven patients with primary endpoint data were available for analysis, 48 in the buddy taping group and 49 in the plaster group. At 12 weeks, median quickDASH scores were the same for both groups (buddy 0, interquartile range [IQR] 0 to 2.3; plaster 0, IQR 0 to 4; difference 0; 95% confidence interval of the difference 0 to 0). Patients in the buddy taping group missed a median 0 days (IQR 0 to 7) of work compared with the plaster group's 2 days (IQR 0 to 14). Other secondary outcome measures were the same in both groups. Conclusion: We found that patients with boxer's fractures who were randomized to buddy taping had functional outcomes similar to those of patients randomized to plaster cast at 12 weeks. We advocate a minimal intervention such as buddy taping for uncomplicated boxer's fractures.