Extremity fractures in the paralysed part of the body can usually be treated with a well padded, lightweight POP slab that can be removed easily for the inspection of underlying skin. A full POP cast should be avoided.
Internal fixation of osteoporotic extremity fractures, on occasions may be an advantage.
Treatment by external fixator often results in considerable hardship without material benefit to the patient. Soft tissue injuries around the shoulders and elbows will need protracted period of informed rehabilitation, bed rest and recuperation.
Contractures to the elbows/knees should not be treated by serial plasters.