Forefoot morphology is determined by toe length. It is hereditary and unlikely to change during a person’s lifetime, although certain factors may lead to modifications. This study examines whether extrinsic factors such as footwear or deformities are associated with changes in the morphology of the forefoot and its pathologies. A study was made of the forefoot morphology, deformities and footwear of 331 participants divided into two populations: a control group (168 participants) and a population of people living in an institution (163 participants with psychiatric disorders). The results show that although Egyptian foot is the most common morphology in both populations, square foot was more prevalent among the women in the control population than among the women in the institution group. In addition, the type of footwear used by the women in the control population was mostly high-heeled constrictive street footwear, compared to the non-constrictive home footwear worn by the women in the institution population, p-value < 0.001. A high prevalence of square feet was observed in the control group women with hallux valgus (HV), p-value 0.008. A relationship was detected between the presence of HV and its prevalence in participants with square foot, concurrent with the use of constrictive footwear and mostly affecting women. The combination of HV and constrictive footwear could explain the high prevalence of the square foot morphology. These footwear characteristics can be considered risk factors in the alteration of the digital formula and aggravation of the deformity suffered in older women.
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