An anchor-in-anchor fixation assembly comprising: at least one anchor-in-anchor system (20; 120) including: a first bone screw (22; 122) including a first threaded shaft (26; 126) and a first head (28; 128), the first threaded shaft (26; 126) extending along a first longitudinal shaft axis and configured to attach to underlying structure, and the first head (28; 128) defining a bore (40;140) extending therethrough along a bore axis, wherein the bore axis and the first longitudinal shaft axis define an acute angle (α); and a second bone screw (24; 124) including a second threaded shaft (42; 142) and a second head (44; 144), the second threaded shaft (42; 142) extending along a second longitudinal shaft axis and configured to attach to underlying structure, wherein the second bone anchor (24; 124) is configured to be inserted into the bore (40; 140); and an intramedullary nail configured to be inserted into a bone canal, the intramedullary nail including a body, the intramedullary nail defining a plurality of apertures (74a; 74b) that extend through the body, characterized in that the intramedullary nail is configured such that when the anchor-in-anchor system (20; 120) is coupled to the intramedullary nail, one of the apertures (74a; 74b) receives at least a portion of the first bone screw (22; 122), and the second bone screw (24; 124) extends outside of the intramedullary nail without passing through the intramedullary nail. at least one anchor-in-anchor system (20; 120) including: a first bone screw (22; 122) including a first threaded shaft (26; 126) and a first head (28; 128), the first threaded shaft (26; 126) extending along a first longitudinal shaft axis and configured to attach to underlying structure, and the first head (28; 128) defining a bore (40;140) extending therethrough along a bore axis, wherein the bore axis and the first longitudinal shaft axis define an acute angle (α); and a second bone screw (24; 124) including a second threaded shaft (42; 142) and a second head (44; 144), the second threaded shaft (42; 142) extending along a second longitudinal shaft axis and configured to attach to underlying structure, wherein the second bone anchor (24; 124) is configured to be inserted into the bore (40; 140); and an intramedullary nail configured to be inserted into a bone canal, the intramedullary nail including a body, the intramedullary nail defining a plurality of apertures (74a; 74b) that extend through the body, characterized in that the intramedullary nail is configured such that when the anchor-in-anchor system (20; 120) is coupled to the intramedullary nail, one of the apertures (74a; 74b) receives at least a portion of the first bone screw (22; 122), and the second bone screw (24; 124) extends outside of the intramedullary nail without passing through the intramedullary nail. a first bone screw (22; 122) including a first threaded shaft (26; 126) and a first head (28; 128), the first threaded shaft (26; 126) extending along a first longitudinal shaft axis and configured to attach to underlying structure, and the first head (28; 128) defining a bore (40;140) extending therethrough along a bore axis, wherein the bore axis and the first longitudinal shaft axis define an acute angle (α); and a second bone screw (24; 124) including a second threaded shaft (42; 142) and a second head (44; 144), the second threaded shaft (42; 142) extending along a second longitudinal shaft axis and configured to attach to underlying structure, wherein the second bone anchor (24; 124) is configured to be inserted into the bore (40; 140); and an intramedullary nail configured to be inserted into a bone canal, the intramedullary nail including a body, the intramedullary nail defining a plurality of apertures (74a; 74b) that extend through the body, characterized in that the intramedullary nail is configured such that when the anchor-in-anchor system (20; 120) is coupled to the intramedullary nail, one of the apertures (74a; 74b) receives at least a portion of the first bone screw (22; 122), and the second bone screw (24; 124) extends outside of the intramedullary nail without passing through the intramedullary nail.