Blender 5.2 or newer. The damage and thickness systems use Geometry Nodes features and the control panel is a Blender 5.2 Extension.

No. Everything also works from the rig custom properties and the modifiers. The add-on just gives you a clean panel with poses, thickness, damage, look presets and studio lighting.

No. It is a stylized-realistic skeleton built procedurally from scratch with anatomically informed proportions and joints. It is made for animation, horror and fantasy art, motion graphics and illustration, not for clinical use.

Yes. The rig uses the same controls as Realistic Rigged Hand, so its pose pack can be imported from the panel. 32 poses are already preloaded.

Yes, the Royalty Free license covers commercial work. Use Freeze Damage (apply) to bake damage and apply the Armature to export the posed bones as FBX or glTF. Materials are procedural, so textures need to be baked for other engines.