Abstract
<jats:p>Combat-related peripheral nerve injuries, particularly of the radial nerve, are a widespread consequence of modern mine-blast and shrapnel trauma, leading to prolonged disability and high rates of functional impairment among service members. The clinical management of these cases is significantly complicated when neuropathy develops secondary to gunshot humeral fractures, which triggers extensive scarring, persistent perineural edema, and secondary nerve trunk ischemia. Despite substantial advancements in military medicine, optimizing physical therapy protocols to accelerate axonal reinnervation and restore hand functional capacity in polystructural injuries remains a highly relevant issue in modern rehabilitation. The aim of the study was to justify and evaluate the effectiveness of a comprehensive physical therapy model for service members with traumatic radial nerve injuries, aimed at preventing secondary complications and achieving optimal functional recovery. The study involved 28 service members diagnosed with traumatic radial neuropathy following shrapnel wounds and humeral osteosynthesis. The intervention group implemented a program including passive and active neuromobilization, sensory training, and functional electrical stimulation based on the biofeedback principle. The control group received standard range-of-motion exercises and passive electrical stimulation. Outcome measures included the Visual Analogue Scale for pain, manual muscle testing, the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) index, and electroneuromyography (ENMG) parameters. Reassessment after 3 months revealed a statistically significant advantage of the comprehensive program in the intervention group across all parameters (p < 0.05). A significant improvement in hand function according to QuickDASH and higher rates of nerve conduction recovery were established. Neurodynamic techniques were found to promote remyelination and reduce neuropathic pain, while active stimulation accelerated the reinnervation of the wrist extensor muscles. The results confirm the pathogenetic validity of the proposed approach and open prospects for its implementation into the rehabilitation system for military personnel at various stages of recovery.</jats:p>