Background: Complementary and alternative medicine (CAM) treatment practices are frequently utilized by patients alongside conventional modern medicine. CAM options are commonly practiced by orthopedic trauma patients and are usually driven by cultural and sometimes religious beliefs. This study aims to evaluate the prevalence, practices and influencing factors of CAM use among orthopedic patients. Methodology: An observational cross-sectional survey study was carried out at the Orthopedic Department fracture clinics in a tertiary trauma center in Riyadh, Saudi Arabia. Participants were recruited from orthopedic fracture clinics and requested to complete a questionnaire survey. Results: Among the 356 surveyed fracture patients, 49.4% reported using CAM. Of these CAM users, 20.5% patients used CAM for the first time after being diagnosed with fracture, while 79.5% of patients had previously utilized CAM and increased their usage after fracture diagnosis. CAM practices were significantly associated with older age, joint reconstructive fracture treatment, and reported disability/dependence. Fenugreek was the most commonly consumed type by 81% of CAM users. The key motivations for CAM use were the perception of enhancing the fracture healing process and maintaining good health. Notably, 61.5% of CAM users reported experiencing improvements in their physical health, while 9.0% of the users experienced adverse effects such as weight gain and joint pain. Conclusion: Our study shed a light on the high prevalence of CAM usage among fracture patients, with Fenugreek being the most popular. Potential influencing factors for CAM practices were investigated including demographic, socioeconomic as well as fracture-related factors. Despite its high prevalence, CAM use is often not discussed with the treating physicians, therefore, increased physician awareness and enhanced patient communication about CAM practices are essential. Further investigations are required to explore CAM adverse effects as well as impact on fracture healing and general health.

Clear cell sarcoma (CCS) is an uncommon malignancy originating from neural crest cells; this type of cancer can mimic a number of other tumors and frequently presents in the lower limbs, but is occasionally found in atypical locations. The present study describes a rare case of a 14‑year‑old girl presenting with a subungual swelling on the right index finger, with the initial impression of a glomus tumor, who underwent unplanned surgical resection at another institution. The histopathological analysis revealed CCS with positive margins, and the patient was therefore referred to an orthopedic oncology specialist King Khalid University Hospital (King Saud University Medical City, Riyadh, Saudi Arabia), for further management. Local and systemic staging workups confirmed localized disease; hence, local control was achieved by amputation at the base of the middle phalanx level, with negative margins achieved without chemotherapy or radiation therapy. Finger tumors may impose diagnostic challenges due to their rarity and similarity with more common benign conditions. A high index of suspicion is important to make an early, accurate diagnosis, and to avoid inappropriate management and poor outcomes. The current case is one of the few published reports of CCS arising in the finger and, to the best of our knowledge, the second pediatric case. Therefore, the present study contributes to the limited literature on CCS presenting in an unusual location such as the hand, with the aim of avoiding errors in diagnosis and management.