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Reasonable functional outcomes for nonoperative management of isolated, closed fifth metacarpal neck fractures with up to 70° angulation have been reported; however, reported outcomes for fractures with greater than 70° angulation are limited. This study describes clinical outcomes of nonsurgically treated fifth metacarpal neck fractures with angulation of greater than 70°. A retrospective review of patients treated between May 1, 2016, and May 1, 2020, included (1) patients aged 18 years and above with an isolated, closed, fifth metacarp