An apparatus for causing compression between bone elements, the apparatus comprising: an elongated shaft comprising a longitudinal inner bore, at least one compression slot, an external surface, a proximal end, and a distal end; the at least one compression slot being in communication with the longitudinal inner bore; at least one tensioning cable aperture, wherein the at least one tensioning cable aperture is in communication with the longitudinal inner bore, wherein the at least one tensioning cable aperture provides at least one of an ingress into the longitudinal inner bore, and an egress out of the longitudinal inner bore for at least one tensioning cable end, wherein the at least one tensioning cable aperture is oriented longitudinally between the proximal end of the elongated shaft and the distal end of the elongated shaft, wherein the at least one tensioning cable aperture is in communication with the external surface of the elongated shaft, at least one tensioning cable clearance slot, wherein the at least one tensioning cable clearance slot is oriented at a longitudinal position, and the at least one compression slot is oriented at a longitudinal position, and wherein the longitudinal position of the at least one tensioning cable clearance slot and the longitudinal position of the at least one compression slot are substantially the same, wherein the at least one tensioning cable clearance slot is in communication with the external surface of the elongated shaft, and wherein the at least one tensioning cable clearance slot is oriented longitudinally between the proximal end of the elongated shaft and the distal end of the elongated shaft, characterized in that the at least one tensioning cable clearance slot is offset about 90 degrees from the at least one compression slot, the at least one tensioning cable clearance slot being operable to allow a tensioning cable to bow radially outward from the longitudinal inner bore to avoid interfering with an insertion of a transverse bolt into the compression slot. an elongated shaft comprising a longitudinal inner bore, at least one compression slot, an external surface, a proximal end, and a distal end; the at least one compression slot being in communication with the longitudinal inner bore; at least one tensioning cable aperture, wherein the at least one tensioning cable aperture is in communication with the longitudinal inner bore, wherein the at least one tensioning cable aperture provides at least one of an ingress into the longitudinal inner bore, and an egress out of the longitudinal inner bore for at least one tensioning cable end, wherein the at least one tensioning cable aperture is oriented longitudinally between the proximal end of the elongated shaft and the distal end of the elongated shaft, wherein the at least one tensioning cable aperture is in communication with the external surface of the elongated shaft, at least one tensioning cable clearance slot, wherein the at least one tensioning cable clearance slot is oriented at a longitudinal position, and the at least one compression slot is oriented at a longitudinal position, and wherein the longitudinal position of the at least one tensioning cable clearance slot and the longitudinal position of the at least one compression slot are substantially the same, wherein the at least one tensioning cable clearance slot is in communication with the external surface of the elongated shaft, and wherein the at least one tensioning cable clearance slot is oriented longitudinally between the proximal end of the elongated shaft and the distal end of the elongated shaft, characterized in that the at least one tensioning cable clearance slot is offset about 90 degrees from the at least one compression slot, the at least one tensioning cable clearance slot being operable to allow a tensioning cable to bow radially outward from the longitudinal inner bore to avoid interfering with an insertion of a transverse bolt into the compression slot.