The purpose of this study was to evaluate the efficacy of a custom-molded leather ankle lacer for treating painful problems of the ankle and hindfoot. The evaluation involved patient self-assessment, clinical examination and radiographic determination of the effectiveness of the ankle lacer.Overall, patients who used the lacer experienced moderate pain relief with significant but not complete restriction of motion. Based on this study and clinical experience, the authors concluded the leather ankle is a compliant and comfortable treatment strategy for patients who desire some retained motion of the ankle and hindfoot without intolerable pain.