Montreal saw record 12 frostbite amputations in 2025, but none this year. Here's why

Winter can be tough to bear. Even more so if you’re homeless.

If there is no place to warm up or change out of soggy boots or damp clothes, continuous exposure to freezing temperatures and wind chill can result in severe frostbite and, in some cases, amputation.

While not all of Montreal’s regional health authorities track frostbite amputations, those that do have recorded 46 cases since 2018.

On average, there are about six frostbite amputations a year.

Montreal hospitals do not log whether a patient is unhoused, but anecdotally, “a large portion of our patients, unfortunately, are really homeless,” said Dr. Ali Izadpanah, a board-certified plastic surgeon. He is also the director of Montreal’s regional burn centre at the CHUM, which treats severe frostbite.

“It does happen, of course, [to] the guy who’s outside for a ski or work, but much, much less often,” he said. 

The worse the frostbite, the higher the chance of amputation.

But despite a long and cold winter, no frostbite amputations have been reported in Montreal so far this year.

The two worst years for frostbite amputations were 2023 and 2025, which both had 12 cases.

The drop in cases could be connected to two differences this winter season: the addition of hundreds of spots in temporary warming shelters around the city and the use of a new drug protocol to treat frostbite, called iloprost.

The use of iloprost to treat frostbite in Canada was first developed in Whitehorse and began to be used more widely last winter in Quebec.

Like burns, frostbite severity ranges from Stage 1 — frostnip —  to 4, where the skin and underlying tissue is usually dead and has turned black, similar to an electrical burn. 

At stages 3 and 4, some sort of surgical reconstruction or amputation is usually needed, said Dr. Izadpanah.

He says the frostbite can only be evaluated once the area has been warmed up.