[Abstract] Objective To investigate the efficacy of mini-plate and bone cement external fixator in treatment of the fifth metacarpal neck fracture. Methods The clinical data of 48 patients with the fifth metacarpal neck fracture from May 2013 to August 2018 were retrospectively analyzed, of which 24 cases were treated with mini-plate and 24 cases with bone cement external fixator. The metacarpophalangeal joint function，finger grip strength and radiographic bone union time were compared between the two groups. Results The patients of two groups were follow-up for 6 to 18 months with an average of 12 months, two groups had significant statistical difference by the metacarpophalangeal joint function（P＜0.05），and there were no significant difference in finger grip strength and radiographic bone union time between the two groups（P＞0.05）. Conclusion Mini-plate and bone cement external fixator is an effective treatment for the fifth metacarpal neck fracture, However,combined with surgical trauma, removal mode and total treatment cost , etc, bone cement external fixator is recommended.