Compression screw apparatuses, systems and methods are disclosed. In one embodiment, the compression screw includes a primary screw and a secondary screw. The primary screw includes an at least partially threaded leading portion and an at least partially threaded trailing portion. The secondary screw includes outer threads and has a central opening which is also threaded and adapted for being screwed onto and matingly engaging the trailing portion of the primary screw. Drivers can be used to rotatably control the primary screw and the secondary screw to cause compression of spaced-apart material, particularly for compression of bone fragments across a fracture line.