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Article Category: Newsroom

Hand Surgery: Precision & Compassion

My journey into the intricate specialty

Dr. Justin Kunes, Wellstar pediatric orthopedic and hand surgeon

Published on March 04, 2025

Last updated 09:02 AM March 04, 2025

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Hand surgery is a unique and intricate field that combines the precision of microsurgery with the compassion required to treat patients of all ages. My journey into this specialized area of medicine comes from a deep passion for helping individuals regain function and improve their quality of life. This article explores my dedication to pediatric hand surgery and minimally invasive adult hand surgery, including arthroscopy and ultrasound-guided procedures such as carpal tunnel and trigger finger release.

The Beginnings of a Passion

From an early age, I was fascinated by the complexity of machines, computers and tools. Until high school, I was convinced that I should become an engineer. However, in the last month of high school I shadowed an orthopedic surgeon and told myself, “I’ll go to medical school if I can do that!” During my medical training, I was fortunate to be able to help many patients in the emergency department to return to their lives and work by treating their hand injuries. I became enamored with the hand’s intricate network of bones, tendons, nerves and muscles that allow for an incredible range of motion and dexterity. Also, in treating children during residency, I wanted to learn more about the growing hand and how I could help children gain the most function. This fascination led me to direct my career in medicine toward a particular focus on hand surgery and pediatric orthopedics.

Pediatric Hand Surgery: A Delicate Balance

Pediatric hand surgery is a particularly rewarding aspect of my practice. Children with congenital hand differences or traumatic injuries require specialized care that addresses both their physical and emotional needs. The challenge lies in the delicate balance of performing intricate surgeries on tiny, developing hands while ensuring minimal disruption to their growth and development.

One of the most fulfilling aspects of pediatric hand surgery is witnessing the resilience and adaptability of young patients. Their ability to recover and adapt to new circumstances is truly remarkable. Whether it is correcting a congenital anomaly like syndactyly (webbed fingers) or repairing a traumatic injury, the goal is always to restore function and enable these children to lead active, fulfilling lives. My favorite pediatric hand surgery is the index pollicization, in which I convert the index finger into a thumb for children who are born without a thumb.

Minimally Invasive Techniques: The Future of Hand Surgery

In recent years, minimally invasive techniques have revolutionized the field of hand surgery. These approaches offer many benefits, including reduced pain, faster recovery times and smaller scars. My practice has increasingly incorporated these techniques, particularly arthroscopy and ultrasound-guided procedures, to provide the best possible outcomes for my patients.

Arthroscopy: Precision Through Small Incisions

Arthroscopy is a minimally invasive surgical technique that involves the use of a small camera, called an arthroscope, to visualize the inside of a joint. This allows for precise diagnosis and treatment of various hand conditions without the need for large incisions. In my practice, arthroscopy works well for conditions such as wrist ligament injuries, ganglion cysts and early-stage arthritis.

The advantages of arthroscopy are myriad. Patients experience less postoperative pain, shorter hospital stays and quicker return to daily activities. Additionally, the smaller incisions result in less scarring, which is particularly important for hand surgery, where stiffness can lead to delayed recovery since tissues must stretch to recover.

Ultrasound-Guided Procedures: Real-Time Precision

Ultrasound-guided procedures have also become a cornerstone of my practice. This technique involves using ultrasound imaging to guide the placement of needles or surgical instruments in real-time. It is particularly useful for conditions such as carpal tunnel syndrome and trigger finger, where precise targeting of the affected area is crucial.

For carpal tunnel syndrome, ultrasound guidance allows for accurate placement of the needle during corticosteroid injections or for the release of the transverse carpal ligament. This results in effective symptom relief with minimal discomfort for the patient. Similarly, for trigger finger, ultrasound guidance ensures precise release of the constricted tendon sheath, leading to improved outcomes and faster recovery.

The Human Connection: Building Trust and Empathy

While the technical aspects of hand surgery are undoubtedly important, the human connection is equally vital. Building trust and empathy with my patients is at the core of my practice. Each patient comes with their own unique story, and understanding their concerns and goals is essential for providing personalized care.

In pediatric hand surgery, this often involves working closely with both the child and their family. Explaining the surgical procedure in a way that is understandable and reassuring helps to alleviate anxiety and build confidence in the treatment plan. For adult patients, particularly those undergoing minimally invasive procedures, clear communication about the benefits and expectations of the surgery is crucial for informed decision-making.

Continuing Education and Innovation

The field of hand surgery is constantly evolving, with new techniques and technologies emerging regularly. Staying at the forefront of these advancements is a priority for me. I am committed to continuous education and regularly attend conferences, workshops and training sessions to refine my skills and learn about the latest developments in hand surgery.

Innovation is also a key aspect of my practice. I actively participate in research studies and collaborate with colleagues to explore innovative approaches and improve existing techniques. This commitment to innovation ensures that my patients receive the most advanced and effective treatments available.

Conclusion: A Lifelong Commitment

My passion for pediatric hand surgery and minimally invasive adult hand surgery comes from my desire to make a meaningful difference in the lives of my patients. The ability to restore function, alleviate pain and improve quality of life is incredibly rewarding. As I continue this journey, I remain dedicated to providing compassionate, cutting-edge care to all my patients, young and old.

Hand surgery is more than just a profession for me; it is a lifelong commitment to excellence, empathy and innovation. Each day brings new challenges and opportunities to gain experience and grow, and I am grateful for the privilege of being able to help my patients achieve their best outcomes.

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Newsroom

Wellstar Proposes New Acworth Area Hospital To Meet Community Need

To address the growing need for hospital beds in Acworth and the surrounding areas, Wellstar Health System is proposing to build a new 230-bed hospital, filing its Letter of Intent with the Georgia Department of Community Health. A Letter of Intent is the first step in the process to obtain a Certificate of Need for a new hospital.

The new hospital would be located on Cobb Parkway across from the Wellstar Acworth Health Park. Wellstar’s long history of service to this community makes it the ideal partner to continue to meet the area's growing healthcare needs. The project will be supported by Wellstar Health System resources, including Wellstar Kennestone Regional Medical Center and Wellstar Paulding Medical Center, and numerous primary, urgent and specialty care locations, which will further enable the project to provide high-quality care in an integrated, coordinated and efficient manner.

Wellstar will file a detailed Certificate of Need application on or before June 23, 2025, that will include architectural renderings and how the hospital would address the community’s health and wellness needs.

“Wellstar is improving access to care, and this new hospital is the latest in a series of projects that do just that,” said Candice L. Saunders, president and CEO of Wellstar Health System. “The area is growing so much that even when our new tower at Wellstar Kennestone opens next year, the region will need more hospital beds. A new hospital in Acworth would fill a crucial need for the region’s medical care.”

Wellstar is improving access to care for communities across Georgia through more than $1.4 billion in major projects, including:

  • Expanding Wellstar Kennestone with a new 200-plus bed tower for additional specialty care,
  • Expanding Wellstar Paulding with a new 56-bed tower and parking deck to meet growing community need,
  • Adding a new oncology center to Wellstar Spalding Medical Center to help keep cancer care local,
  • Committing to upgrading and expanding facilities in the Augusta area, including building a new 100-bed hospital and medical office building in Columbia County for the largest county in Georgia without its own hospital,
  • Adding primary care, pediatric, urgent care and specialty services in the communities Wellstar serves, and
  • Partnering with the Augusta University Medical College of Georgia Center for Digital Health to provide rural hospitals with access to specialty care.

The new hospital would be part of a Wellstar system that provides more than $1 billion each year in charity and uncompensated care—more than any health system in Georgia. Wellstar is also a leader in medical education through its partnerships with academic institutions, accelerates healthcare technology and innovation, and is recognized by Fortune magazine as one of the 100 Best Places to Work in America.

“Access to healthcare has been expanding throughout Cobb County, but we still have an unmet need for hospital beds in the northern portion of our county,” said Lisa Cupid, chairwoman of the Cobb County Board of Commissioners. “Wellstar is deeply committed to our region, and we’re grateful that they recognized this need and are stepping forward with a solution.”

“Acworth’s population grew fivefold in ten years, and we continue to attract people who want to live and work in our area,” said Tommy Allegood, mayor for the City of Acworth. “The City of Acworth has been expanding our critical infrastructure and creating a place where families will want to stay for generations. A hospital would be extremely beneficial to our community, and we appreciate Wellstar’s willingness to meet our need.”

Wellstar is headquartered in Cobb County and is deeply involved in the area, tracing its heritage to 1950 when Kennestone Hospital opened. In keeping with its community roots, Wellstar will establish a community advisory council to honor every voice throughout the Certificate of Need process.

“My patients are from all walks of life, but they share a desire for a hospital that’s closer to home, especially those who have chronic conditions or are elderly,” said Dr. Michaele Brown, a Wellstar primary care doctor in Acworth. “We live in a vibrant, growing area. Our patients’ access to all levels of healthcare should be just as vibrant and that includes a hospital where they can quickly get the level of care they need when they need it.”

“We will involve the community in every step of this process, and make sure this hospital meets the community’s needs for generations to come,” said Saunders.

In addition to providing care for generations of families, Wellstar actively supports community health and well-being through partnerships with nonprofit, civic and business organizations, as well as academic institutions. Through these partnerships, Wellstar serves all of its neighbors’ needs, ranging from access to healthcare to food and housing insecurity to educational support and career development.

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Dr. Nasarachi Onyeuku, a radiation oncologist at Wellstar, standing with one of the two TrueBeam linear accelerators in use for cancer care at Wellstar Cobb Cancer Center

Newsroom

Wellstar Cobb Cancer Center Expands Treatment Services

New radiation technology and refreshed waiting and treatment areas are expanding world-class cancer treatment at Wellstar Cobb Cancer Center.

Cancer care in forward motion

Wellstar Cobb Cancer Center recently installed its second TrueBeam linear accelerator, which treats various cancers, including brain, head and neck, prostate, breast, lung, skin and gastrointestinal tumors. With the linear accelerator, clinicians can adjust the size and shape of beams to a tumor’s shape and spare healthy tissue.

With the second linear accelerator, Wellstar Cobb can offer patients more flexible and convenient scheduling. “An additional linear accelerator can lead to timely treatment starts and shorter wait times,” said Dr. Nasarachi Onyeuku, a radiation oncologist at Wellstar. “It expands our ability to treat more patients with cutting-edge care, continuing our commitment to bringing world-class cancer treatment closer to home.”

In addition to state-of-the-art external beam radiotherapy, TrueBeam delivers precise, high-dose stereotactic body radiotherapy (SBRT) targeting tumors in the body. It also provides stereotactic radiosurgery (SRS) for brain or spine cancer treatment. Patients will typically receive one to five treatments.

Patient-centered care at Wellstar Cobb

Wellstar Cobb Cancer Center recently renovated its treatment areas, front desk and waiting room, making it more welcoming and comforting for patients and their families. Within the treatment areas, the suite where patients receive high-dose radiation brachytherapy, a targeted treatment that involves placing radioactive material directly into tumors or near them, also underwent renovations.

“The beautifully designed space enhances patient comfort, offering a calm, supportive environment,” Dr. Onyeuku said. “We’re currently treating breast, cervical, uterine and skin cancers, with plans to expand to other cancer types. It’s advanced, efficient care—delivered close to home and with compassion.”

Early detection and support services

Cancer care begins with prevention and early detection. Wellstar Cobb is home to a lung cancer STAT Clinic, where specialists collaborate to diagnose and begin treatment within as little as 14 days. According to research by the Cleveland Clinic, patients can spend up to eight weeks on average visiting different specialists before starting a treatment plan. Earlier treatment can lead to the best possible outcomes.

Patients at Wellstar Cobb receive support at every stage of their treatment. These services include:

  • Emotional support from a social worker
  • Lymphedema therapy for patients with excess fluid and swelling
  • Meal planning with a dietitian
  • Monthly support group
  • Pain management
  • Physical therapy
  • Transportation assistance

“We have a superb team and state-of-the-art treatment here at Wellstar Cobb Cancer Center. And we’re backed by the resources of a nationally recognized health system,” Dr. Onyeuku said. “We are thrilled that our technology enhancements allow us to serve more people with exceptional cancer treatment.”

Learn more about cancer care in Cobb.

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Highlights

5 Strategies to Strengthen Your Mental Health

Mental health is an essential part of whole-person care. Whether you're feeling overwhelmed or want to build resilience, small steps can make a big impact.

At Wellstar, we’re here to support your mental well-being and help you thrive. Our Behavioral Health team offers specialized care close to home, so you can feel your best both physically and mentally.

Here are five expert-backed strategies to help protect your mental health and strengthen your overall wellness.

Pay attention to early signs of stress.

Recognizing stress early is key to managing it effectively. When stress becomes chronic, it can affect both your mental and physical health. Learning to identify warning signs can help you take action before it escalates.

This is true across all areas of life, including the workplace, where job stress can quietly build over time and lead to more serious mental health concerns if left unaddressed.

“Paying attention to feelings of emotional exhaustion and general cynicism is important,” said Dr. Ryan Breshears, a board-certified clinical health psychologist and chief behavioral health officer at Wellstar. “Those are the foundational signs of occupational burnout, which certainly affects our well-being in the workplace, but when unchecked, can also spill over into our personal lives.”

That spillover can show up as irritability, mood changes, social withdrawal or insomnia. “Any of those could point to a problem that warrants intervention,” Dr. Breshears said.

Treat your whole health to support your mental well-being.

Mental and physical health are deeply interconnected—and we shouldn’t treat them in silos. At Wellstar, integrated care is a key part of our approach.

“I think the days of talking about problems that are physical problems versus mental problems are over,” said Dr. Breshears. “We have a body of research now and decades of science that show the interplay between the physical and the emotional.”

He explained that changes in thinking patterns can trigger physiological shifts in heart rate, stress hormone levels and more. Recognizing these mind-body connections can help you take a more proactive approach to your mental health.

“Wellstar is making a concerted effort to deconstruct old ideas about mental health and remove barriers to access,” Dr. Breshears added. “For example, we’re bringing behavioral health into primary care, cardiac care, pediatrics and women’s health. We want to strategically integrate behavioral health services wherever patients are receiving care.”

By treating the whole person and bringing behavioral health into every corner of healthcare, Wellstar is helping people take charge of their well-being in a way that’s compassionate, connected and convenient.

Prioritize recovery.

Stress is inevitable, and recovery is essential. Without it, your mind and body stay in overdrive, increasing your risk for burnout and long-term health issues. Taking time to recover is not a sign of weakness—it’s a strategy for resilience.

“Our bodies are designed to return to baseline, what we call homeostasis, after high-stress periods,” Dr. Breshears said. “Research suggests it's often the failure to prioritize recovery, not the stress itself, that actually contributes to the most lasting problems.”

Dr. Breshears shared a study comparing elite marathon runners to non-elite runners. The surprising finding? Elite runners were better at identifying stress early and adjusting their pace to recover, ultimately helping them perform better.

That same principle can apply to your mental health. If you notice signs of stress—like fatigue, irritability or changes in focus—take time to reset. That might mean getting more sleep, going for a walk, reaching out to a friend or seeking professional support.

Being intentional about recovery helps you maintain balance, build resilience and continue showing up for what matters most.

Nurture relationships and workplace well-being.

Meaningful relationships are a powerful buffer against stress. For many people, the workplace is a central source of community—and a critical place to nurture mental health.

“We’re social creatures,” said Dr. Breshears. "Having environments where people come in and feel good about their day-to-day interactions is really important.”

Dr. Breshears said it starts with employers being committed to understanding the inadvertent threats to their team’s well-being and removing barriers to care.

“First, I think we have to pay attention to the occupational drivers of stress on our employees and commit to resolving those issues,” he explained. “All of the human resources and benefits in the world will fail if we’re not also working upstream to eliminate the root causes. Secondly, we need to establish clear pathways so people can easily access support without all the stumbling blocks and delays they often run into.”

Employers who lead with empathy—and prioritize flexibility, compassion and connection alongside performance—help create cultures where people feel empowered to seek help when needed.

“We have to ensure that we have accessible resources,” Dr. Breshears said. “People bring their personal struggles into the workplace, and take their struggles in the workplace home. The lines have certainly blurred.”

Know when to seek help.

While self-care and support systems can go a long way, there are times when professional help is essential. Mental health conditions are common—and treatable. The sooner you seek help, the better.

This is especially true for men, who often face cultural and emotional barriers when it comes to seeking support.

“Men on average tend to delay help-seeking more than women,” Dr. Breshears said. “And this is especially true when men are suffering. Frankly, it's a mortality issue.” He noted that men are more likely to die by suicide and experience substance abuse disorders, which makes early intervention even more critical.

Dr. Breshears also emphasized the need to remove barriers and promote action: “We have to create environments in which people feel safe to talk about the struggles that they’re having.”

If you’re struggling, don’t wait. Explore Wellstar Behavioral Health services and find the support you need today.

If you or someone you know is in crisis, call or text 988 for the Suicide and Crisis Lifeline, or contact the Crisis Text Line by texting TALK to 741741.

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