TOS can cause those same nerves to get irritated too, and it's difficult to sort it out -but do-able by very good and expert TOS docs.

Have you been to a specialist on our list of drs? { should have said has he been to any }
some drs say they know TOS but not really experienced at dx and txing it.
http://neurotalk.psychcentral.com/thread135.html

There is specific MRI/MRA tests that can help to pin point where the trouble is.
I hate to see him get these elbow and wrist surgeries just as a "maybe" fix.

It is possible that he has a triple crush syndrome also, but I would make sure that the cause is clear before having any surgery - one big reason is possible scar tissue build up afterward.

I hope he has had clear xrays and MRIs to check for extra cervical ribs as well as any other anomalies in structures.

useful TOS info-
http://neurotalk.psychcentral.com/thread84.html

If you can list the tests he's had already and maybe his most bothersome symptoms, we might be able to give you more detailed suggestions.
What is his avg daily pain level?

We have many threads on PT - good and bad - there are some great videos in the useful sticky showing PT, Triggerpoint, chiro adjustments ...