This seminar chronicled the case of a puppy that suffered bilateral accessory carpal bone fractures after jumping from a second-story window. A history was taken and a physical exam was performed to create a problem list that included pain, crepitus, and hyperextension of both carpi. Differentials were discussed, and a diagnostic plan was developed to narrow the list of possible diagnoses through the use of radiography. Bilateral accessory carpal bone fractures were identified on lateral carpal radiographs. Three possible methods of treatment were evaluated to treat the accessory carpal bone fractures: external coaptation alone, surgical excision of fracture fragments, and internal fixation of the fractures. The owners chose internal screw fixation, and the procedure was successful.