The zygomatic bone and zygomatic arch are located in the lateral aspect of the midface and their shape is of aesthetic importance. Because of their prominent location, they are one of the parts of the midface that are prone to fracture, mostly due to direct lateral or lateral anterior violence, and their fractures are called zygomatic and zygomatic arch fractures. If the fracture of zygoma and zygomatic arch occurs at the same time, it is called zygomatic complex fracture. Zygomatic fractures often occur in combination with maxillary fractures and are called zygomaticomaxillary complex fractures. The zygomatic bone is involved in the composition of the inferior extraorbital wall, and the fracture often affects the bony orbit and orbital contents, and is called a zygomatic-orbital complex fracture. Surgical anatomy The zygomatic bone has an irregular quadrangular shape with four prominences present: the frontal, temporal, maxillary, and infraorbital rims, which are connected to the frontal, temporal, maxillary, and pterygoid bones, respectively. The fracture of the zygomatic complex opens the following four sutures: the zygomatic-frontal, zygomatic-temporal, zygomatic-mandibular, and zygomatic-pteriorbital sutures, and spreads to the surrounding bones. The zygomatic arch consists of the temporal process of the zygomatic bone and the zygomatic process of the temporal bone. The sensory nerve of the zygomatic bone is the second branch of the trigeminal nerve. Its zygomatic, facial, and temporal branches pass through small foramina on the surface of the zygomatic body and innervate sensation in the buccal and anterior temporal regions. The infraorbital nerve exits the infraorbital foramen anteriorly through the orbital floor and innervates sensation in the anterior cheek, nasal side, upper lip, and anterior maxillary teeth. The lateral canthal ligament attaches to the zygomatic tubercle posterior to the outer orbital rim. Fractures of the zygomatic complex often present with downward displacement of the lateral canthus due to displacement of the zygomatic bone. Imaging examination Imaging examination helps to clarify the fracture diagnosis and serves as evidence for forensic medicine, and also clarifies the extent of the fracture. 1. Plain film: Waldron’s position is the most ideal film position in plain film to evaluate zygomatic complex fractures alone. Zygomatic arch fracture alone can be examined by zygomatic arch axial position or modified skull base position. 2.CT : CT scan is the gold standard for zygomatic fracture imaging. CT images in axial and coronal positions can show displaced fractures of the zygomatic sutures and allow observation of orbital wall fractures and orbital soft tissue injuries. 3D reconstructed images of CT can provide an overall view of the fracture characteristics and determine the type of fracture, displacement and degree of comminution.