A compression screw for applying compression at a bone joint, the compression screw comprising: - an axial screw body (12, 30) extending from a distal end to a proximal end, the distal end including a series of bone engaging threads configured to be self-drilling and self-tapping, and the proximal end including a head which defines a radially extending shoulder, - wherein two proximal rotary cutting structures (36, 37) are defined proximally of the bone engaging threads, the two rotary cutting structures (36, 37) configured to be self-drilling such that a proximal portion of the axial screw body cuts into and advances within a bone of the bone joint as the axial screw body is advanced, - wherein each of the two rotary cutting structures (36, 37) extend further radially outward than an adjacent portion of the compression screw disposed distally of each of the two rotary cutting structures (36, 37), and - wherein a first one of the two rotary cutting structures (36, 37) includes a plurality of cutting flutes, - wherein a second one of the two rotary cutting structures (36, 37) is defined by a series of external threads on the head such that the head is self-countersinking, - wherein the axial screw body (12, 30) is defined by a bone screw and a compression sleeve, the bone screw extending from a bone screw distal end to a bone screw proximal end, the bone screw distal end defining the axial screw body distal end including the series of bone engaging threads, and the bone screw proximal end including a series of sleeve engaging threads extending radially from a shaft of the bone screw, and - wherein the compression sleeve comprises a tubular body extending from a compression sleeve distal end to a compression sleeve proximal end, the compression sleeve proximal end defining the axial screw body proximal end including the head, the compression sleeve distal end defining the first rotary cutting structure and wherein the compression sleeve includes internal threads configured to engage with the sleeve engaging threads such that the compression sleeve and bone screw are threadably adjustable relative to one another. - an axial screw body (12, 30) extending from a distal end to a proximal end, the distal end including a series of bone engaging threads configured to be self-drilling and self-tapping, and the proximal end including a head which defines a radially extending shoulder, - wherein two proximal rotary cutting structures (36, 37) are defined proximally of the bone engaging threads, the two rotary cutting structures (36, 37) configured to be self-drilling such that a proximal portion of the axial screw body cuts into and advances within a bone of the bone joint as the axial screw body is advanced, - wherein each of the two rotary cutting structures (36, 37) extend further radially outward than an adjacent portion of the compression screw disposed distally of each of the two rotary cutting structures (36, 37), and - wherein a first one of the two rotary cutting structures (36, 37) includes a plurality of cutting flutes, - wherein a second one of the two rotary cutting structures (36, 37) is defined by a series of external threads on the head such that the head is self-countersinking, - wherein the axial screw body (12, 30) is defined by a bone screw and a compression sleeve, the bone screw extending from a bone screw distal end to a bone screw proximal end, the bone screw distal end defining the axial screw body distal end including the series of bone engaging threads, and the bone screw proximal end including a series of sleeve engaging threads extending radially from a shaft of the bone screw, and - wherein the compression sleeve comprises a tubular body extending from a compression sleeve distal end to a compression sleeve proximal end, the compression sleeve proximal end defining the axial screw body proximal end including the head, the compression sleeve distal end defining the first rotary cutting structure and wherein the compression sleeve includes internal threads configured to engage with the sleeve engaging threads such that the compression sleeve and bone screw are threadably adjustable relative to one another.