A bone fixation assembly comprising: an elongate fixation member (110, 120, 150, 170, 180) comprising: a central longitudinal axis; a first portion configured to be coupled within a first intramedullary canal of a first bone fragment of a bone; a second portion configured to be coupled within a second intramedullary canal of a second bone fragment of the bone to provide fixation of the second bone fragment relative to the first bone fragment; and a flexible tensioning element (61, 62) couplable to the first and second portions of the elongate fixation member (110, 120, 150, 170, 180) to secure the elongate fixation member to the bone, wherein: a first end (63, 65) of the flexible tensioning element (61, 62) is couplable with a second end (64, 66) of the flexible tensioning element (61, 62) to secure the elongate fixation member (110, 120, 150, 170, 180) to the bone; and when the first end (63, 65) of the flexible tensioning element (61, 62) is coupled to the second end (64, 66) of the flexible tensioning element, the flexible tensioning element is configured to span a bone fracture intermediate the first bone fragment and the second bone fragment to preload the bone fracture in compression to resist tensile force imparted across the bone fracture, thereby maintaining fixation of the first bone fragment relative to the second bone fragment. an elongate fixation member (110, 120, 150, 170, 180) comprising: a central longitudinal axis; a first portion configured to be coupled within a first intramedullary canal of a first bone fragment of a bone; a second portion configured to be coupled within a second intramedullary canal of a second bone fragment of the bone to provide fixation of the second bone fragment relative to the first bone fragment; and a central longitudinal axis; a first portion configured to be coupled within a first intramedullary canal of a first bone fragment of a bone; a second portion configured to be coupled within a second intramedullary canal of a second bone fragment of the bone to provide fixation of the second bone fragment relative to the first bone fragment; and a flexible tensioning element (61, 62) couplable to the first and second portions of the elongate fixation member (110, 120, 150, 170, 180) to secure the elongate fixation member to the bone, wherein: a first end (63, 65) of the flexible tensioning element (61, 62) is couplable with a second end (64, 66) of the flexible tensioning element (61, 62) to secure the elongate fixation member (110, 120, 150, 170, 180) to the bone; and when the first end (63, 65) of the flexible tensioning element (61, 62) is coupled to the second end (64, 66) of the flexible tensioning element, the flexible tensioning element is configured to span a bone fracture intermediate the first bone fragment and the second bone fragment to preload the bone fracture in compression to resist tensile force imparted across the bone fracture, thereby maintaining fixation of the first bone fragment relative to the second bone fragment. a first end (63, 65) of the flexible tensioning element (61, 62) is couplable with a second end (64, 66) of the flexible tensioning element (61, 62) to secure the elongate fixation member (110, 120, 150, 170, 180) to the bone; and when the first end (63, 65) of the flexible tensioning element (61, 62) is coupled to the second end (64, 66) of the flexible tensioning element, the flexible tensioning element is configured to span a bone fracture intermediate the first bone fragment and the second bone fragment to preload the bone fracture in compression to resist tensile force imparted across the bone fracture, thereby maintaining fixation of the first bone fragment relative to the second bone fragment.