To the Editor.— In reply to Dr. Hilsinger's letter ( 214 :1326, 1970), the severely sprained ankle is truly a problem. This is in no small measure an outcome of inadequate diagnosis and treatment. The orthopedic literature is liberally sprinkled with papers emphasizing necessity for strain x-ray films of the ankle if there is a high index of suspicion of complete ligament tears. The presence of a complete ligament tear is an indication for surgical repair in some hands but at the very least necessitates the application of a short leg cast. The use of halfway measures compounds the difficulties. The use of external supportive measures for incomplete or stretching injuries of these ligaments is of course perfectly acceptable.