In 2011, the idea to publish an open access textbook for hand surgery was born by a few enthusiastic individuals. They were initially motivated by their wish to spread knowledge and scientific results without barriers. One of the leading aims was to preserve the copyright for the authors. Another aspect was to provide also hand surgeons in economic limited countries or in the middle of nowhere comprehensive background for high level hand surgery. A dynamic process started, during which the team grew quickly as more and more renowned hand surgeons, societies and institutions supported the project. They received most valuable support in terms of outreach and community-building by the International Federation of Societies for Surgery of the Hand (IFSSH) and the Association of the Scientific Medical Societies in Germany (AWMF). ZB MED - Leibniz Information Centre Life Sciences, home of the open access publisher German Medical Science, has accompanied the project from its very beginning, giving advice concerning conceptual issues regarding digital publishing, editorial issues, and making technical ends meet. The project was up for discussion in conferences and congresses concerning Open Access (OA) and Open Educational Resources (OER; Figure 1) in order to collect all important aspects, considerations and suggestions.

We also introduced the upcoming book at Congresses for Hand Surgery, at the FESSH-Congress in Antwerp/Belgium 2012 and the IFSSH Congress in Delhi/India 2013 (Figure 2). At these opportunities the Editorial Board and first authors met and defined conditions, structure, the table of contents and responsibilities.

In autumn 2011 the non-profit organization behind the project, “Handchirurgie Weltweit e.V.” was founded as the legal base for financial realization. At the same time German Medical Science agreed to publish the book as a pilot for a series “Living Handbooks” without any restrictions. They allocated the Editorial Office and initiated the development of an adequate template system. Software engineers who took part in the development of Wikipedia and others supported the team. They identified Drupal™, an open-source content management system, to best fulfill all verbalized requirements. It took more than one year to develop the software toolbox with most of the specifications. But at September 2014, we were able to present the beta-version with a first scientific but comprehensive subchapter concerning Dupuytren’s Disease.