Foot morphological variations between different ethnicities and sex: a systematic review

Foot morphology varies between individuals of different sex and ethnicities across the world. Most commonly measured are foot length and breadth which have practical implications in shoe design and forensics. This review aims to identify relevant papers on the topic of foot morphological variation, and compare results. Searches were carried out on PubMed, Scopus and Web of Science until January 2020. Live human subjects age 16 and over were included the study. Included studies were analysed using the Anatomical Quality Assurance (AQUA) Checklist (Tomaszewski et al., 2017) to determine the quality and reporting from the studies. Any study using cadavers, paediatric participants and those with any underlying condition that affected foot shape were excluded. This review included 17 studies involving 15,235 participants from across the globe. Evidence suggests that foot morphology differs among ethnicities and sex. Most significant differences were found between the Asian population when compared to Australian and Pacific Islanders. Females had smaller foot morphological measurements across all studies with the exception of lateral talocalcaneal angle and calcaneal pitch in two African studies which indicate the higher arch profile of females in this ethnic group. This review highlights the differences in foot morphology that exist between individuals of the same and different ethnicities and sex. Foot length is most commonly used for stature estimation and sex prediction and is more accurate for prediction than foot breadth. Results highlight the need for global shoe and orthotic manufacturers to broaden fit of footwear for worldwide inclusion and continued research with greater sample size and ethnicities to be studied.