ORIGINAL COMMUNICATION A Novel Interactive Anatomic Atlas of the Hand S. GEHRMANN, 1 K.H. HO ¨ HNE, 2 * W. LINHART, 1 B. PFLESSER, 2 A. POMMERT, 2 M. RIEMER, 2 U. TIEDE, 2 J. WINDOLF, 1 U. SCHUMACHER, 3 AND J.M. RUEGER 1 1 Department of Trauma-, Hand-, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany 2 Institute of Medical Informatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany 3 Department of Anatomy II: Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Classical anatomic atlases cannot provide the spectrum of views and the detail required in modern diagnostic and surgical techniques. Computer modeling opens the possibility to choose any view from one single model. A computerized model of the hand is presented, which has been obtained by segmentation and graphic modeling of the Visible Human dataset. In addition to being able to choose arbitrary viewpoints, it allows interrogation of the chosen views by mouse click. We believe the functions of these new kinds of atlases are superior to the classical ones. Clin. Anat. 19:258–266, 2006. V V C 2005 Wiley-Liss, Inc. Key words: digital anatomic atlas; Visible Human; volume visualization; hand; medical education; surgery planning INTRODUCTION The development of microsurgical techniques over the past decades has enabled significant advances in hand surgery. In microsurgery, anatomical details previously considered unimportant now have new relevance. This need for more detail and realism has led to improvements in recent atlases of the hand, including illustrations of surgical approaches and in- formation pertaining to microvascular supply and re- constructive interventions. Anatomy education software has become increas- ingly available in the past several years. Programs have been developed for the general public, as well as for medical professionals, at all levels of training. Typically, these programs have the form of an elec- tronic book complete with static images, often enriched with animations, and containing examina- tion questions for content testing purposes. One ex- ample is the hand atlas by McGrouther et al. (2000). In printed atlases, however, it is difficult to present all subtle structures for any given surgical situation, with a finite number of illustrations. Modern 3D atlases, by contrast, and as described in this article, offer a critical advantage in that an unlimited num- ber of views can be generated from a single com- puter model. In addition, state-of-the-art computer- based anatomy provides 3D models which a user can interact with, for dissection and interrogation. Such models have a significant advantage that they are not only suited for anatomy instruction and refer- ence, but they also allow simulation of surgical approaches and procedures (Golland et al., 1999; Visible Human Dissector, 2004). The first computer- based atlas of this kind was the VOXEL-MAN inter- active atlas of the brain (Ho ¨ hne et al., 1992, 2001), followed by an atlas of the internal organs (Pommert et al., 2001; Ho ¨ hne et al., 2003). The gross anatomi- cal detail of such atlases (Fig. 1) is certainly suffi- cient; however, in the case of a structure with many delicate details, such as the human hand, computer models do not yet have the spatial resolution compa- rable to drawings in a classic atlas. Thus, it is the *Correspondence to: Karl Heinz Hoehne, Institute of Medical Informatics, University Medical Center Hamburg-Eppendorf (UKE), Martini-Str. 52, 20246 Hamburg, Germany. E-mail: hoehne@uke.uni-hamburg.de Received 7 April 2005; Revised 3 August 2005; Accepted 15 September 2005 Published online 21 December 2005 in Wiley InterScience (www. interscience.wiley.com). DOI 10.1002/ca.20266 V V C 2005 Wiley-Liss, Inc. Clinical Anatomy 19:258–266 (2006)