The osteochondral and chondral fractures (OCF) of the patella are one of the commonest injuries of adolescence, the incidence of which has risen rapidly due to increasing awareness and better radiological imaging techniques. The management is challenging as it not only involves management of the OCF but also the management of comorbidities associated with it. While acute cases can be managed with a variety of options ranging from conservative or removal or refixation, depending on the size and type of the fragment; the chronic cases must be managed as per any chronic osteochondral patellar lesion. However, in both the acute and chronic conditions, the associated comorbidities must be managed. So far, refixation of the OCF using sutures seems to be the best option in acute conditions.