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  • SAGE Publications  (9)
  • Lee, Jin Woo  (9)
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  • SAGE Publications  (9)
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  • 1
    Online-Ressource
    Online-Ressource
    Percutaneous Lateral Ligament Reconstruction with Allograft for Chronic Lateral Ankle Instability
    SAGE Publications ; 2012
    In:  Foot & Ankle International Vol. 33, No. 2 ( 2012-02), p. 99-104
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 33, No. 2 ( 2012-02), p. 99-104
    Kurzfassung: Background: The majority of lateral ankle instability can be treated successfully with conservative method. However, if such treatments fail, surgical treatment should be considered. A wide variety of procedures have been introduced to treat chronic lateral ankle instability. The percutaneous method avoids dissection which is associated with open surgery and can lead to excessive morbidity. The purpose of this study was to evaluate the clinical and radiological outcomes of percutaneous lateral ligament reconstruction with an allograft in the treatment of chronic lateral ankle instability. Methods: Between October 2006 and April 2009, percutaneous lateral ligament reconstruction using an allograft was performed on 15 ankles in 13 patients for chronic lateral ankle instability. The patients included in this study satisfied at least one of the following criteria: a previously failed reconstruction of the ligament, severe ankle instability (more than 15 degrees of talar tilt, more than 10 mm of anterior drawer), general laxity of ligaments, body mass index (BMI) higher than 25. The mean followup period was 18.1 (range, 12 to 40) months. The grafted tendon was secured by double tenodeses at both the talus and calcaneus or triple tenodeses which included a fibular tenodesis. The clinical outcomes were evaluated with Visual Analogue Scale (VAS) for pain, Karlsson-Peterson ankle score, and patients' subjective satisfaction. The radiological results were evaluated using the varus tilting angle and the anterior displacement distance. Results: The VAS improved from preoperative 3.7 ± 2.2 to 1.6 ± 1.3 at the last followup ( p = 0.002). The Karlsson-Peterson ankle score increased from 54.2 ± 8.8 to 80.9 ± 7.2 ( p = 0.001). Patients were satisfied in 13 cases (86.7%) with excellent or good results. Radiologically, the mean varus tilting angle was 15.5 ± 4.4 degrees preoperatively and 7.3 ± 3.6 at the last followup ( p = 0.001). The anterior drawer distance was 10.1 ± 3.3 mm preoperatively and 7.2 ± 2.7 mm at last followup ( p = 0.001). Conclusion: We believe percutaneous lateral ligament reconstruction with allograft to be a useful method as a salvage procedure for the treatment of severe and complicated types of chronic lateral ankle instability. Furthermore, the minimal invasiveness of this technique provides a good cosmetic outcome and we found it to be a technically easy and fast procedure. Level of Evidence: Comparative Case Series
    Materialart: Online-Ressource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.3113/FAI.2012.0099
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2012
    ZDB Id: 2129503-7
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 2
    Online-Ressource
    Online-Ressource
    Clinical Comparison of the Osteochondral Autograft Transfer System and Subchondral Drilling in Osteochondral Defects of the First Metatarsal Head
    SAGE Publications ; 2012
    In:  The American Journal of Sports Medicine Vol. 40, No. 8 ( 2012-08), p. 1824-1833
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 40, No. 8 ( 2012-08), p. 1824-1833
    Kurzfassung: Osteochondral defects of the first metatarsal head can deteriorate to osteoarthritis of the first metatarsophalangeal joint if left untreated. Treatment options for osteochondral defects of the first metatarsal head vary widely. Purpose: To compare the clinical outcomes of the osteochondral autograft transfer system with those of subchondral drilling for the treatment of osteochondral defects of the first metatarsal head. Study Design: Cohort study; Level of evidence, 3. Methods: The authors retrospectively evaluated 24 cases of osteochondral defects of the first metatarsal head treated operatively; 14 patients underwent subchondral drilling (group A), while 10 were treated with the osteochondral autograft transfer system (group B). The association of variables of osteochondral defects with clinical outcomes was assessed in each group. Clinical outcomes were evaluated according to a visual analog scale (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale, and the Roles and Maudsley score. The Tegner activity scale and an activity rating scale were used to determine the activity levels. Results: The mean VAS score in both groups was significantly improved (from 6.9 ± 0.9 to 3.9 ± 1.3 in group A and from 7.4 ± 0.8 to 3.4 ± 1.2 in group B; P 〈 .05). No difference was noted between the 2 groups at final follow-up ( P = .651). The mean AOFAS score in both groups was significantly improved (from 62.9 ± 5.8 to 73.2 ± 8.2 in group A and from 65.0 ± 4.1 to 81.5 ± 5.8 in group B; P 〈 .05). There was a significant difference in mean AOFAS score between the 2 groups at final follow-up ( P = .032). Large defect size (≥50 mm 2 ) and the existence of a subchondral cyst were significant predictors of unsatisfactory clinical outcomes in group A ( P = .047 and P = .019, respectively). Multivariate analyses showed a defect size larger than 50 mm 2 was associated with significantly worse outcomes on the last follow-up VAS and AOFAS scores in group A ( P = .005 for VAS and P = .006 for AOFAS). There was no association of defect size and subchondral cyst with clinical outcomes in group B ( P 〉 .05). No association was found between location of the defect area and clinical outcome in either group. Conclusion: For osteochondral defects larger than 50 mm 2 or when a subchondral cyst exists, the osteochondral autograft transfer system could potentially be used as a treatment of choice for osteochondral defects of the first metatarsal head to restore functionality of the metatarsophalangeal joint.
    Materialart: Online-Ressource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546512449292
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2012
    ZDB Id: 2063945-4
    SSG: 31
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 3
    Online-Ressource
    Online-Ressource
    Factors Associated With the Clinical Outcomes of the Osteochondral Autograft Transfer System in Osteochondral Lesions of the Talus : Second-Look Arthroscopic Evaluation
    SAGE Publications ; 2012
    In:  The American Journal of Sports Medicine Vol. 40, No. 12 ( 2012-12), p. 2709-2719
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 40, No. 12 ( 2012-12), p. 2709-2719
    Kurzfassung: Identifying factors associated with the clinical outcomes of the osteochondral autograft transfer system would be helpful for treating patients with an osteochondral lesion of the talus. Purpose: To investigate the clinical and second-look arthroscopic results of the osteochondral autograft transfer system and to identify the prognostic factors associated with this procedure. Study Design: Case series; Level of evidence, 4. Methods: The authors retrospectively evaluated 52 ankles that underwent osteochondral autograft transfer for a medial osteochondral lesion of the talus. Second-look arthroscopies were performed at a mean of 13.1 months postoperatively. Clinical outcomes were evaluated according to a visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Tegner activity scale. Statistical analyses were performed to identify various prognostic factors associated with the clinical outcomes. Results: The mean VAS, AOFAS, and Tegner activity scale scores were all significantly improved from 6.9 ± 0.9 to 3.3 ± 1.4 (VAS), from 67.4 ± 4.9 to 82.6 ± 7.8 (AOFAS), and from 3.0 ± 0.8 to 3.9 ± 0.9 (Tegner; P 〈 .05). Regarding overall patient satisfaction with the operation, 49 (95%) patients reported good to excellent results. Prognostic factors including the patient’s age, sex, body mass index, duration of symptoms, defect size and depth, location of osteochondral lesion of the talus, and the existence of a subchondral cyst did not significantly influence clinical outcomes ( P 〉 .05), except for body mass index on the Tegner activity scale score ( P = .021). Significant differences were observed among clinical outcomes for second-look arthroscopy according to the presence of soft tissue impingement and uncovered areas around the graft ( P 〈 .05). The VAS and AOFAS score at the last follow-up were significantly worse when the articular surface of the tibial plafond at the malleolar osteotomy site was uneven ( P = .031 and .012, respectively). Conclusion: This study showed that the articular surface of the tibial plafond at the malleolar osteotomy site, soft tissue impingement, and uncovered areas around the graft were important factors affecting the clinical outcomes, as observed through second-look arthroscopy. Therefore, surgeons should restore the articular surface accurately after the osteotomy, and more caution should be taken to avoid soft tissue impingement and uncovered areas around the graft when performing osteochondral autograft transfer.
    Materialart: Online-Ressource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546512461132
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2012
    ZDB Id: 2063945-4
    SSG: 31
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 4
    Online-Ressource
    Online-Ressource
    Limb Salvage in Severe Diabetic Foot Infection
    SAGE Publications ; 2011
    In:  Foot & Ankle International Vol. 32, No. 1 ( 2011-01), p. 31-37
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 32, No. 1 ( 2011-01), p. 31-37
    Kurzfassung: Background: The purpose of our study was to determine the efficacy of a management algorithm that includes negative pressure wound therapy (NPWT) in diabetic feet with limb-threatening infection. Materials and Methods: Forty-five septic diabetic feet were treated with NPWT between 2006 and 2008. After emergent abscess evacuation, early vascular intervention was performed if necessary. Debridement, with or without partial foot amputation, was followed by NPWT. Wound progress was measured using a digital scanner. A limb was considered salvaged if complete healing was achieved without any or with minor amputation through or below the ankle. The mean followup after complete wound healing was 17 (range, 6 to 35) months. Results: Thirty-two cases (71%) were infected with two or more organisms. Negative pressure wound therapy was applied for 26.2 ± 14.3 days. The median time to achieve more than 75% wound area granulation was 23 (range, 4 to 55) days and 104 (range, 38 to 255) days to complete wound healing. Successful limb salvage was achieved in 44 cases (98%); 14 (31%) without any amputation and 30 (67%) with partial foot amputations. Total number of operations per limb was 2.4 ± 1.3. One case of repeated infection and necrosis was managed with a transtibial amputation. There were no complications associated with NPWT. Conclusion: This study provides the outcome of a management algorithm which includes NPWT in salvaging severely infected diabetic feet. With emergent evacuation of abscess, early vascular intervention and appropriate debridement, NPWT can be a useful adjunct to the management of limb-threatening diabetic foot infections. Level of Evidence: IV, Retrospective Case Series
    Materialart: Online-Ressource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.3113/FAI.2011.0031
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2011
    ZDB Id: 2129503-7
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 5
    Online-Ressource
    Online-Ressource
    The Effect of an Ossicle of the Lateral Malleolus on Ligament Reconstruction of Chronic Lateral Ankle Instability
    SAGE Publications ; 2010
    In:  Foot & Ankle International Vol. 31, No. 3 ( 2010-03), p. 191-196
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 31, No. 3 ( 2010-03), p. 191-196
    Kurzfassung: Background: Ossicles at the tip of the lateral malleolus are frequently found in patients with chronic lateral ankle instability (CLAI). However, the relationship between the presence or the size of an ossicle and the outcome of ligament reconstruction is poorly understood. Therefore, this study aimed to evaluate the effect of an ossicle at the tip of the lateral malleolus on ligament reconstruction in CLAI. Materials and Methods: Seventy-four ankles with chronic lateral instability that received lateral ligament reconstruction using a modified Broström technique between January 2001 and March 2007 were included. The mean followup was 47 (range, 25 to 89) months. Ankles were divided into 2 groups: the ossicle group (26 ankles, 35.1%) and the non-ossicle group (48 ankles, 64.9%). Then, depending on the size, the ossicle group was subdivided into small (less than 10 mm, 14 ankles) and large ossicles (greater than 10 mm, 12 ankles). Pre- and postoperative Karlsson-Peterson ankle scores and findings on stress radiographs were compared between the groups. Results: Both the ossicle and non-ossicle groups improved significantly on stress radiographs without difference between the groups. Karlsson-Peterson ankle scores showed functional improvement in each group, however, the mean score at last followup was significantly lower in the ossicle group ( p = 0.01). The prevalence of an osteochondral lesion of the talus was significantly higher in the ossicle group ( p = 0.046). In ankles with large ossicles, varus stability was achieved but anterior displacement of the talus was not improved after ligament reconstruction. Conclusion: The surgeon should be aware of the inferior functional outcome in ankles with ossicles. Also, when the ossicle is large, excision and modified Broström technique may not be suitable to achieve mechanical anteroposterior stability. Therefore, fusing the ossicle to the fibular tip or using other methods of ligament reconstruction can be considered when performing ligament reconstruction in CLAI with associated large ossicles. Level of Evidence: III, Retrospective Comparative Study
    Materialart: Online-Ressource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.3113/FAI.2010.0191
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2010
    ZDB Id: 2129503-7
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 6
    Online-Ressource
    Online-Ressource
    Supramalleolar Osteotomy With Bone Marrow Stimulation for Varus Ankle Osteoarthritis : Clinical Results and Second-Look Arthroscopic Evaluation
    SAGE Publications ; 2014
    In:  The American Journal of Sports Medicine Vol. 42, No. 7 ( 2014-07), p. 1558-1566
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 42, No. 7 ( 2014-07), p. 1558-1566
    Kurzfassung: Supramalleolar osteotomy (SMO), which redistributes the load line within the ankle joint, has been reported as an effective treatment for varus ankle osteoarthritis. However, no study has examined cartilage regeneration in the medial compartment of the ankle after SMO. Hypothesis/Purpose: This study aimed to investigate the clinical and radiological outcomes of SMO and to identify the association between the outcomes of SMO and cartilage regeneration evaluated by second-look arthroscopy. The hypothesis was that cartilage regeneration would be an important predictor of the outcomes of SMO and that arthroscopic marrow stimulation would aid in cartilage regeneration. Study Design: Case series; Level of evidence, 4. Methods: A total of 31 ankles were retrospectively evaluated after arthroscopic marrow stimulation with SMO for varus ankle osteoarthritis; second-look arthroscopy was conducted for all these ankles. Clinical outcome measures included a visual analog scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Radiological outcome variables included the tibial-ankle surface angle (TAS), talar tilt (TT), and tibial-lateral surface angle (TLS), and progression of degenerative arthritis of the ankle was assessed. In the second-look arthroscopy, cartilage regeneration was evaluated using the International Cartilage Repair Society (ICRS) grade. Results: The mean ± standard deviation VAS and AOFAS scores were 7.1 ± 0.8 and 62.9 ± 4.0 preoperatively, and they significantly improved to 3.4 ± 1.3 and 83.1 ± 7.5, respectively ( P 〈 .001, for both) at the time of the second-look arthroscopy (mean, 13.2 months postoperatively). However, at final follow-up (mean, 27.4 months postoperatively), they were significantly decreased to 4.1 ± 1.6 and 79.9 ± 8.0, respectively, compared with the values at second-look arthroscopy ( P 〈 .001, for both). The mean TAS, TT, and TLS improved significantly after SMO but showed no significant correlation with the clinical outcomes and ICRS grade ( P 〉 .05 for all three). At second-look arthroscopy, the ICRS overall repair grades were normal in 1 (3%), nearly normal in 7 (23%), abnormal in 13 (42%), and severely abnormal in 10 (32%). Progressive degenerative arthritis was observed in 13 cases (42%). The ICRS grade was significantly associated with the clinical outcomes ( P 〈 .0001) and development of degenerative arthritis of the ankle joint ( P = .002). Conclusion: This study showed improved clinical outcomes after SMO for varus ankle osteoarthritis in comparison to the preoperative assessments. Furthermore, the ICRS grade was significantly associated with the clinical outcomes of SMO at final follow-up and significantly associated with the development of degenerative arthritis of the ankle joint. Therefore, arthroscopic marrow stimulation should be considered with SMO to ensure adequate cartilage regeneration. However, given the ICRS grades observed at the time of the second-look arthroscopies and the progression of degenerative arthritis in 42%, the long-term prognosis in this group of patients is uncertain.
    Materialart: Online-Ressource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546514530669
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2014
    ZDB Id: 2063945-4
    SSG: 31
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 7
    Online-Ressource
    Online-Ressource
    Soft Tissue Impingement Syndrome of the Ankle: Diagnostic Efficacy of MRI and Clinical Results after Arthroscopic Treatment
    SAGE Publications ; 2004
    In:  Foot & Ankle International Vol. 25, No. 12 ( 2004-12), p. 896-902
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 25, No. 12 ( 2004-12), p. 896-902
    Kurzfassung: Background: Soft-tissue impingement syndrome is now increasingly being recognized as a significant cause of chronic ankle pain. The aim of this study was to investigate the diagnostic accuracy of contrast-enhanced, fat-suppressed, three-dimensional (3D), fast-gradient-recalled acquisition in the steady state with radio-frequency-spoiling (CE 3D-FSPGR) magnetic resonance imaging (MRI), and to evaluate the clinical outcome of arthroscopic treatment of soft-tissue impingement associated with the ankle trauma. Methods: This study reviewed 38 patients who had preoperative MRI and arthroscopic treatment of chronic ankle pain after trauma. The CE 3D-FSPGR MRI was used to evaluate the chronic ankle pain, and the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score was used to evaluate the clinical results after arthroscopic treatment. Results: The CE 3D-FSPGR MRI showed a sensitivity of 91.9%, a specificity of 84.4%, and an accuracy of 87.5% in diagnosing synovitis and soft tissue impingement. All patients had excellent or good outcomes after arthroscopic debridement. Conclusion: The results of this study suggest that a preoperative fat-suppressed CE 3D-FSPGR MRI is highly beneficial in diagnosing synovitis and soft-tissue impingement and that arthroscopic debridement of the synovitis or soft-tissue impingement has a good clinical outcome.
    Materialart: Online-Ressource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.1177/107110070402501209
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2004
    ZDB Id: 2129503-7
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 8
    Online-Ressource
    Online-Ressource
    Bone Marrow Stimulation for Osteochondral Lesions of the Talus: Are Clinical Outcomes Maintained 10 Years Later?
    SAGE Publications ; 2021
    In:  The American Journal of Sports Medicine Vol. 49, No. 5 ( 2021-04), p. 1220-1226
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 49, No. 5 ( 2021-04), p. 1220-1226
    Kurzfassung: Arthroscopic bone marrow stimulation (BMS) is considered the first-line treatment for osteochondral lesions of the talus (OLTs). However, the long-term stability of the clinical success of BMS remains unclear. Purpose: To investigate the long-term clinical outcomes among patients who underwent BMS for OLT and to identify prognostic factors for the need for revision surgery. Study Design: Case series; Level of evidence, 4. Methods: A retrospective analysis was performed on 202 ankles (189 patients) that were treated with BMS for OLT and had a minimum follow-up of 10 years. The visual analog scale for pain, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, and the Foot and Ankle Outcome Score (FAOS) were assessed by repeated measures analysis of variance. Prognostic factors associated with revision surgery were evaluated with Cox proportional hazard regression models and log-rank tests. Results: The mean lesion size was 105.32 mm 2 (range, 19.75-322.79); 42 ankles (20.8%) had large lesions (≥150 mm 2 ). The mean visual analog scale for pain improved from 7.11 ± 1.73 (mean ± SD) preoperatively to 1.44 ± 1.52, 1.46 ± 1.57, and 1.99 ± 1.67 at 1, 3 to 6, and ≥10 years, respectively, after BMS ( P 〈 .001). The mean ankle-hindfoot score also improved, from 58.22 ± 13.57 preoperatively to 86.88 ± 10.61, 86.17 ± 10.23, and 82.76 ± 11.65 at 1, 3 to 6, and ≥10 years after BMS ( P 〈 .001). The FAOS at the final follow-up was 82.97 ± 13.95 for pain, 81.81 ± 14.64 for symptoms, 83.49 ± 11.04 for activities of daily living, 79.34 ± 11.61 for sports, and 78.71 ± 12.42 for quality of life. Twelve ankles underwent revision surgery after a mean 53.5 months. Significant prognostic factors associated with revision surgery were the size of the lesion (preoperative magnetic resonance imaging measurement ≥150 mm 2 ; P = .014) and obesity (body mass index ≥25; P = .009). Conclusion: BMS for OLT yields satisfactory clinical outcomes at a mean follow-up of 13.9 years. The success of the surgery may depend on the lesion size and body mass index of the patient.
    Materialart: Online-Ressource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546521992471
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2021
    ZDB Id: 2063945-4
    SSG: 31
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
  • 9
    Online-Ressource
    Online-Ressource
    Comparison of Multi-Drug Injection Versus Placebo After Hallux Valgus Surgery
    SAGE Publications ; 2011
    In:  Foot & Ankle International Vol. 32, No. 9 ( 2011-09), p. 856-860
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 32, No. 9 ( 2011-09), p. 856-860
    Kurzfassung: Background: Hallux valgus surgery is followed by a significant amount of postoperative pain. Local multi-drug injection can be an option for pain control, but few clinical studies exist. Methods: Between May 2008 and July 2009, 30 consecutive patients (60 feet) received simultaneous bilateral proximal osteotomies for the correction of hallux valgus deformities. Each patient received local infiltration of the test solution made with ropivacaine, morphine, ketorolac, and epinephrine on one foot and same amount of normal saline on the other foot. The test side and the control side were randomly selected and both the patient and the surgeon remained blinded until the end of the data collection. Results: The multi-drug injection resulted in significantly less pain at 4 hours after the operation through the night of the first postoperative day. The difference in visual analogue scale (VAS) between the two sides was most significant at 8 hours after the operation, and then gradually decreased through the first and second postoperative day. Mean satisfaction VAS was significantly higher on the injection side (8.2 ± 0.9) compared to the control side (6.2 ± 1.9, p 〈 0.0001). Conclusion: Local multi-drug injection was easy to perform and safe and effective in reducing pain and enhancing patient satisfaction after hallux valgus surgery. Level of Evidence: I, Prospective, Randomized, Controlled Double Blind Study
    Materialart: Online-Ressource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.3113/FAI.2011.0856
    Sprache: Englisch
    Verlag: SAGE Publications
    Publikationsdatum: 2011
    ZDB Id: 2129503-7
    Standort Signatur Einschränkungen Verfügbarkeit
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    Online-Ressource
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