Dundee revisited--25 years of a total amputee service.

The Dundee Limb Fitting Centre has provided an integrated rehabilitation programme for the amputee since 1965. A review of 1846 primary amputees is discussed. During this period a dramatic change in the above-knee/below-knee (AK/BK) ratio has been achieved with 71% BK and 26% AK occurring in 1989. Over 80% of all amputees, the majority being elderly with peripheral vascular disease, were successfully fitted with a prosthesis. Final discharge home or to a residential home for the elderly was achieved in 76.2% of cases with 3.6% dying in the Unit. Bilateral amputation occurred in 18% of cases of whom 48% were BK-BK. Overall 66% were successfully fitted with a prosthesis. The results demonstrate the advantages of an integrated approach to the amputation and consequent rehabilitation.