Not hardly.
They run just fine on 100LL.
Physically different in how they look, yes. Radials are still reciprocating internal combustion engines, most using pushrods and lifters to operate overhead valves, just like the horizontally opposed engines you are accustomed to.
To start to understand the radial, you have to look at the time period when it was extremely popular and in use. During that time, inline air-cooled engines suffered from cooling issues, something that a radial did not have (side note: cooling issues with inlines is what led to the liquid cooled inlines like the Merlin). In competetion with an inline of similar horsepower, the radial gave more horsepower per pound, more efficient in combat (didn't lose coolant, overheat and seizure), plus the radial is more mechanically efficient (think of it this way... a radial would have two crankshaft bearings as opposed to multiple bearings in an inline. Cut down weight, increase efficiency). With the advantages of the radial, also came the aerodynamic inefficiency of a large frontal area. That, along with the less horsepower needed for the Cessna and Piper designs helped lead to the emergence of the horizontally opposed engine as your "everyday engine" in aircraft manufacturing.
As far as "understanding"... this design is about 100 years old. Truth be told, the Wright Whirlwind (J-5) is considered to be the first truly reliable aircraft engine was introduced in 1925 (this engine powered Lindbergh's Ryan NYP). With that in mind, there are fewer and fewer mechanics and pilots with experience operating a radial engine. That is where the "understanding" part comes in. Even though they operate the same as a horizontally opposed engine mechanically, if you treat it the same, you are probably going to shorten the overhaul interval of the engine.
One of the biggest "gotchas" is that radials often suffer from hydraulic lock, a condition cause by oil seeping into the rocker cover area, and in severe cases, into the cylinder between the valves and the piston. This condition is the reason you see pilots or ground crews pulling the prop through several times before they start the engine. If you try and start a radial with a severe enough hydraulic lock, you are pretty much going to blow a cylinder off the airplane. (Note: this oil seepage is what causes the smoke on startup). Furthermore, even though radials can be fairly simple mechanically to work on (some are not - see Waco's post) they do require some extra attention that a horizontally opposed engine generally does not.