Structural properties of the fibular band in congenital total absence of the fibula.

Nine children with unilateral total congenital absence of the fibula were examined by magnetic resonance imaging (MRI), and histological study of the fibular band was performed in four of them. Both examinations revealed two types of fibular band. In type I, it was identical to fibula on MRI appearance, and histological studies revealed hyaline cartilage in the area of the lateral malleolus. In this type partial excision of the band allowed the foot to be corrected. In type II, the band directly attached to the calcaneus without any evidence of hyaline cartilage, and the feet could be corrected only by total excision. We suggest partial excision of the band in type I and total excision in type II as the initial treatment of congenital total absence of the fibula.