Dr. Raymond (Rocco) Monto talks about this treacherous, icy weather in different terms from most of us. He calls it his orthopedic stimulus package.

When your work involves repairing the strains, sprains and breaks which accompany frozen ground, these are busy times. He reckons business is up at least 25 per cent.

Miserable as the weather has been over recent weeks, it brings with it opportunity and profit for some, like plumbers, snowplow guys and even canny retailers, although few others could claim the kind of boost to business Dr. Monto is experiencing.

“That 25 per cent increase I’m talking about is just in the volume of trauma,” said the West Tisbury orthopedic surgeon. “That’s not even including the increase in the wear and tear stuff, like rotator cuff injuries and tendonitis. Like the guy who spends all weekend shoveling his driveway and then shows up here on Monday, or the person who hurts himself scraping ice off the windows.”

Of course, winter always brings a fair number of injuries, usually the result of what Dr. Monto calls “weekend warrior” ski trips.

“But the slip and fall ones are much higher this winter than in years past. We’re seeing many, many more wrist fractures, ankle fractures and that kind of stuff, than we do normally.

“Especially, unfortunately, among older people who have trouble getting around at the best of times,” he said.

“These freeze-thaw cycles we’re having are particularly good fodder for orthopedics,” said Dr. Monto. The treacherous surface known as black ice is also known as black gold to an orthopedic surgeon. It pads the wallet and hones the skills.

“I cut my teeth in the Philadelphia ice storm of 1993,” Dr. Monto said. “That’s where I learned to fix hip fractures; when I first began to practice, that was my big introduction to the world of trauma. Thirty-five fractures in a weekend; that’s how you learn.

“Unfortunately, I’m in a growth business.”

You don’t hear about many growth businesses in this ugly economic climate, but the ugly natural climate is helping a few at least.

Like Jerry Goodale, whose quarry provides all the sand which the towns and the state then spread over Island roads.

If there seems to be a lot of that dirty brown gray sand about, there is. Mr. Goodale said he did not have exact figures on how much his company had provided this winter, but it was somewhere between 3,000 and 4,000 tons.

“Picked up, it costs them $5.50 a ton,” he said.

January’s storms, then, have been not a bad little earner for Mr. Goodale. Likewise for the guys who drive snow- plows, you might think.

But Richard T. Olsen, whose company does excavation most of the year and runs a crew of up to six who plow in Tisbury when it snows, said the work was at best a “gap filler” for his people.

“Normally, we don’t really care to do it. By the time you buy the plows, and break things and replace them, it’s not a real money-maker,” he said, adding:

“But it’s welcome this year, because we’re not tied up with much of anything else. It gives hours to the men.”

It means not having to lay people off.

Plumbing and heating contractor Chris L. Meyer also has found a little comfort in the icy weather, although it is to some extent — pardon the pun — cold comfort.

“The bottom line is, yes we have got work out of the cold weather, but business certainly isn’t pretty,” said Mr. Meyer, adding: “I’ve been in business since ’72 and I haven’t seen it this bad. This is scary.”

While burst pipes bring in some extra business, it’s not much, particularly when it is shared among the many plumbers on Island.

“It’s not enough to say we’re doing well in this economy,” he said. “We’re not taking a whole lot to the bank.”

Nor is anyone else. Only this week, he said, someone who had been laid off by another contractor had come and stuffed a resume under the door.

And while there are some jobs you can do without wondering if the customer can really afford it — he cites the recent case of a certain congressman whose outdoor shower had blown up into “majestic white sculpture of frozen water” — there are others where he can’t help but think about the hardship behind it.

The worst thing, he said, was that the real growth area lately was not in burst pipes, but in shutting down services to houses that have been subject to foreclosure.

“I think we’ve got more business from going out to close-ups than we have from freeze-ups. It’s money in my pocket but somebody else is suffering. I don’t like that,” Mr. Meyer said.

One man who is doing lots of business and not embarrassed to be doing it is David Burke, a licensed public insurance adjuster from Edgartown.

He works not for the insurers but for the insured who have suffered losses, so that, as he puts it, “You tell the insurance company what they owe you, rather than them telling you what they owe you.”

Said Mr. Burke: “I haven’t been this busy, I think, since 2005 in regards to insurance claims coming through my office. I’ve probably had at least two dozen frozen pipe losses and a couple of fires. I’m not yet involved in any of the recent fires.”

But it’s not just the weather, per se, that is keeping him busy; it’s the fact that the insurance companies, which are in financial difficulties themselves, are more than usually reluctant to pay up.

“The insurers have been hit very hard — think of AIG for example — and they’re trying hard to protect their remaining assets. It’s hard not only to recover what’s due to you, it’s hard even to get a response, given the number of people they’ve laid off,” he said. He continued:

“Everyone has cut staff. And they will do everything they can to mitigate their exposure.

“Now with a winter like this, there’s a big influx of claims and lack of manpower to get through them quickly. So, yeah, I’m pretty busy.”

Retailers, as we all know, are not so busy, but even there, the cold weather has provided a few opportunities.

Belinda Ritchie, general manager and buyer for the Green Room in Tisbury, said footwear sales were up. Water and snow-proof boots, of course. She has also had a rash of people inquiring about this year’s hot accessory for cold weather, Yaktrax, a sort of strap on crampon which gives your shoes traction on ice.

“The other thing we’re selling a lot more of is bags,” she said. “I can only guess that’s because people are going away.”

Flying, fleeing south, probably.

Not Dr. Monto, though. His vacation plans are on hold and he’ll be sticking around, as long as people are slipping around.