Resurgo Protocol: Comprehensive Conservative Rehabilitation for Compression-Ischemic Radial Neuropathy (Retrospective Case Series, n=11)

Objective: To present and evaluate the clinical results of the comprehensive conservative protocol "Resurgo" in 11 patients diagnosed with compression-ischemic radial neuropathy, with particular attention to the dynamics of pain, muscle tone, and restoration of active motor function. Methods: A multicomponent conservative regimen was applied to 11 patients with clinically confirmed compression-ischemic radial neuropathy between January 2021 and December 2024. The protocol combined a strictly regulated 5-day local cycle of alternating gels and compresses, weekly subcutaneous injections of hyaluronidase 64 IU with novocaine 0.5% in the area of suspected fibrous scar, systemic neuroprotective pharmacotherapy including ipidacrine 20 mg three times daily, cerebrovin 5 mL intramuscularly, liposom forte 1 capsule daily, and tolperisone 150 mg three times daily, alongside a cyclical functional rehabilitation program. Monitoring was performed weekly with standardized assessment of pain using the Visual Analog Scale, range of motion measured in degrees, and muscle tone evaluated using the Modified Ashworth Scale. Statistical analysis included descriptive statistics and Wilcoxon signed-rank test for paired comparisons. Results: The cohort comprised 11 patients with median injury duration of 5 months (range 1-36 months) and median follow-up of 12 weeks (range 4-19 weeks). Baseline Visual Analog Scale scores averaged 6.8 ± 2.6 (mean ± standard deviation), decreasing to 2.1 ± 1.3 at 4-6 weeks, representing a mean reduction of 69.1% (p < 0.001). Pain reduction of at least 50% was achieved in 9 out of 11 patients (81.8%) within the first 6 weeks. In the index case with 1.5-year chronicity, Visual Analog Scale decreased from 10/10 to approximately 1/10 by day 25, with minimal active wrist extension emerging between weeks 7-12. Modified Ashworth Scale scores decreased from median 3 (range 2-4) to median 1 (range 0-2) by week 6. Active range of motion improved in 8 out of 11 patients (72.7%), with greater improvement observed in patients treated within 6 months of injury. Adverse events occurred in 3 patients (27.3%), consisting of local dermatitis, with one severe case requiring protocol modification. No systemic adverse events were reported during the treatment period. Conclusion: The Resurgo protocol demonstrated statistically significant and clinically meaningful effects in alleviating pain, reducing pathological muscle tone, and stimulating motor function recovery in this case series. The intervention showed particular efficacy when initiated within 6 months of injury. Prospective randomized controlled trials with larger sample sizes and extended follow-up periods are warranted to establish definitive efficacy and optimal patient selection criteria.