Anthropometric Foot Variations in Children: A Cross-Sectional Study Supporting Sex-Based Last Design.

Abstract

<h4>Introduction</h4>Proper shoe fit is essential for healthy foot development in children. Despite growing interest in the ergonomics of pediatric footwear, scientific evidence on sex-based foot morphology remains limited. Current unisex shoe lasts may not adequately accommodate anatomical differences between boys and girls, particularly from mid-childhood onward.<h4>Methods</h4>A cross-sectional, observational study was conducted involving 1214 school-aged children (680 boys and 534 girls) between the ages of 1 and 16. Three-dimensional (3D) foot scans were used to obtain detailed anthropometric data, including toe length, ball area, ball perimeter, and metatarsal dimensions. Sex differences were assessed using independent-samples t-tests, and statistical significance was set at p < 0.05.<h4>Results</h4>Significant sex-based differences were found across several key foot dimensions. Boys exhibited larger ball area (mean right foot: 1021.35 vs. 865.85 mm² in girls, p < 0.001), greater ball perimeter (207.54 vs. 192.39 mm, p < 0.001), and wider and higher metatarsal regions. These differences persisted even when toe length was held constant, suggesting divergent growth patterns in foot morphology. The findings indicate that a single unisex last may not be appropriate for children, especially from shoe size 32 onwards.<h4>Conclusions</h4>This study provides robust anthropometric evidence supporting the need for sex-specific shoe last design in pediatric populations. Incorporating such data into footwear manufacturing could enhance ergonomic fit, improve comfort, and promote healthy motor development in children. Further longitudinal and multicenter research is needed to establish global standards for pediatric footwear.<h4>Trial registration</h4>ClinicalTrials.gov identifier: NCT05386992.