Nine children with unilateral total congenital absence of the fibula were e
xamined 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 appeara
nce, and histological studies revealed hyaline cartilage in the area of the
lateral malleolus. In this type partial excision of the band allowed the f
oot to be corrected. In type II, the band directly attached to the calcaneu
s without any evidence of hyaline cartilage, and the feet could be correcte
d 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.