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Classification of frostbite injuries

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Frostbite injuries can be classified into grades 1 to 4 depending on the clinical presentation after rewarming (1,2)

  • grades 1 to 2 comprising superficial frostbite injuries
    • grade 1, cyanosis is absent, and the risk of amputation is minimal
    • grade 2 frostbite presents with cyanosis on the distal phalanx of fingers or toes, and is associated with a moderate risk of amputation
  • grades 3 to 4 deep frostbite injuries
    • grade 3 frostbite injury
      • cyanosis up to the metacarpophalangeal joint (MCP; base of the fingers) or metatarsophalangeal joint (MTP; middle of the foot)
      • bears a high risk of amputation
    • grade 4 injuries
      • cyanosis is seen proximal to the MCP or MTP joint
      • the risk of amputation is almost 100%

Reference:

  1. Sheridan RL, Goverman JM, Walker TG. Diagnosis and treatment of frostbite. N Engl J Med. 2022 Jun 9;386(23):2213-20.
  2. McIntosh SE, Freer L, Grissom CK, et al. Wilderness Medical Society clinical practice guidelines for the prevention and treatment of frostbite: 2024 update. Wilderness Environ Med. 2024 Jun;35(2):183-97.

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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