Surgical Treatment of Anterior Tarsal Tunnel Syndrome: A Systematic Review and Meta-analysis

Anterior tarsal tunnel syndrome (ATTS) is a rare compressive neuropathy of the deep fibular nerve, characterized by pain and paresthesia on the dorsum of the foot. Causes include trauma, osteophytes, and space-occupying lesions. Surgical treatment is considered when conservative management fails. To conduct a systematic review and meta-analysis on the effectiveness of surgical treatment for pain control associated with ATTS. A comprehensive search was performed in the PubMed, BVS, Science.gov, and SciELO databases, with no restrictions on language or publication date. The Population, Intervention, Comparison and Outcome (PICO) strategy guided study selection, including those addressing surgical intervention for ATTS with relevant clinical data. Methodological quality was assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Eight studies were included, totaling 68 patients who underwent surgery. The most commonly reported symptoms were dorsal foot pain, paresthesia, and muscle weakness. Most surgical procedures led to significant symptom improvement, with success rates ranging from 90% to 100%. Only one mild complication was reported (wound dehiscence). Surgery proved to be an effective and safe approach for treating ATTS, offering pain relief and functional recovery. However, the limited number of robust studies restricts the generalizability of the findings and highlights the need for further research with greater methodological rigor.