I thought I read somewhere that there's a 32 bit version of explorer that you can
run to use your shell extensions. Alternatively you may add a 32 bit OS to another partition(such as XP) or, use an older computer for the 32 bit shell extension stuff and put it on a network. Now if you have a router File & Printer sharing is much easier to set up than it used to be. A guy on another board just bought a Quad Core PC with 64 bit Vista and was concerned about not being able to run some old 16 bit apps he still wanted to use. His solution was to keep the old PC next to the new one to run the old apps.
I use a kvma switch because on my desk there's only room for one monitor mouse and keyboard. But when I buy a new PC I only have to buy the tower. If the new PC doesn't run some of my favorite apps I run them on the old PC until things catch up with the new machine and/or OS. Although with Shell Extensions it's really convenient to click in explorer so I can imagine it's a PITA to go without.
Video is changing though(still using a CRT screen) so eventually I'll probably have to bite the bullet and get a 16x9 digital monitor. Then I'll have to get a bigger desk.