Zygomaticomaxillary Complex Fractures

  • Jill MelicherEmail author
  • Jeffrey A. Nerad


The zygomaticomaxillary complex is an essential anatomic element of the aesthetic facial skeleton. The zygomaticomaxillary complex (ZMC) is comprised of zygoma and its articulations to the zygomatic arch and maxilla. The zygoma is a quadrangular bone that provides the structural support of the malar eminence, makes up the anterolateral wall and inferotemporal floor of the orbit and the lateral aspect of the inferior orbital rim. Posterolaterally the zygoma articulates with the zygomatic process of the temporal bone, forming the zygomatic arch. The masseter muscle, essential for mastication, inserts on the zygomatic arch. The arch also provides the contour to the lateral cheek, protecting the temporalis muscle and coronoid process of the mandible. Medially, the zygoma articulates with the maxilla to make up the medial aspect of the inferior orbital rim and floor of the orbit. The maxilla also makes up the anterior face of the facial skeleton and is responsible for housing the teeth. Superiorly, the frontal process of the zygoma articulates with the zygomatic process of the frontal bone, forming the frontozygomatic suture.


Coronoid Process Zygomatic Arch Orbital Floor Bony Fragment Zygomatic Process 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Nerad J. Techniques in ophthalmic plastics and reconstructive surgery: a personal tutorial. Saunders/Elsevier Printed in China; 2010.Google Scholar
  2. 2.
    Bogusiak K, Arkuszwski P. Characteristics and epidemiology of zygomaticomaxillary complex fractures. J Craniofac Surg. 2010;21(4):1018–23.PubMedCrossRefGoogle Scholar
  3. 3.
    Arosarena OA, Fritsch TA, Hsueh Y, Aynehchi B, Haug R. Maxillofacial injuries and violence against women. Arch Facial Plast Surg. 2009;11(1):48–52.PubMedCrossRefGoogle Scholar
  4. 4.
    Ellis III E, el-Attar A, Moos KF. An analysis of 2,067 cases of zygomatico-orbital fracture. J Oral Maxillofac Surg. 1985;43(6):417–28.PubMedCrossRefGoogle Scholar
  5. 5.
    Fujii N, Yamashiro M. Classification of malar complex fractures using computed tomography. J Oral Maxillofac Surg. 1983;41(9):562–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Yanagisawa E. Symposium on maxillo-facial trauma. 3. Pitfalls in the management of zygomatic fractures. Laryngoscope. 1973;83(4):527–46.PubMedCrossRefGoogle Scholar
  7. 7.
    Knight JS, North JF. The classification of malar fractures: an analysis of displacement as a guide to treatment. Br J Plast Surg. 1961;13:325–39.PubMedCrossRefGoogle Scholar
  8. 8.
    Gillies HD, Kilner JP, Stone D. Fractures of the malar-zygomatic compound with a description of a new x-ray position. Br J Surg. 1927;14:651.CrossRefGoogle Scholar
  9. 9.
    Shumrick KA, Kersten RC, Kulwin DR. Smith CP Criteria for selective management of the orbital rim and floor in zygomatic complex and midface fractures. Arch Otolaryngol Head Neck Surg. 1997;23(4):378–84.CrossRefGoogle Scholar
  10. 10.
    Lederman IR. Loss of vision associated with surgical treatment of zygomatic-orbital floor fracture. Plast Reconstr Surg. 1981;68(1):94–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Karlan MS, Cassisi NJ. Fractures of the zygoma. A geometric, biomechanical, and surgical analysis. Arch Otolaryngol. 1979;105(6):320–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Chuong R, Kaban LB. Fractures of the zygomatic complex. J Oral Maxillofac Surg. Apr 1986;44(4):283–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Appling WD, Patrinely JR, Salzer TA. Transconjunctival approach vs subciliary skin-muscle flap approach for orbital fracture repair. Arch Otolaryngol Head Neck Surg. 1993;119(9):1000–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Wray RC, Holtmann B, Ribaudo JM, Keiter J, Weeks PM. A comparison of conjunctival and subciliary incisions for orbital fractures. Br J Plast Surg. 1977;30(2):142–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Zingg M, Laedrach K, Chen J, et al. Classification and treatment of zygomatic fractures: a review of 1,025 cases. J Oral Maxillofac Surg. Aug 1992;50(8):778–90.PubMedCrossRefGoogle Scholar
  16. 16.
    Stanley Jr RB. The zygomatic arch as a guide to reconstruction of comminuted malar fractures. Arch Otolaryngol Head Neck Surg. 1989;115(12):1459–62.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Ophthalmic Plastics, Orbit and Reconstructive SurgeryManagement of Zygomaticomaxillary Complex Fractures, Minnesota Eye Consultants, P.A.MinneapolisUSA
  2. 2.Department of Ophthalmic Plastics, Orbit and Reconstructive SurgeryCincinnati Eye InstituteCincinnatiUSA

Personalised recommendations