A bone fixation element is described. The bone fixation element includes first and second channels, a connection channel, and at least one fenestration. The first channel includes a first proximal channel portion and a first distal channel portion. The first proximal channel portion extends from a proximal end of the first channel toward a distal end, and the first distal channel portion extends from the first proximal channel portion to the distal end. The connection channel extends between the distal end of the first channel and a distal end of the second channel such that the first channel is in fluid communication with the second channel via the connection channel. The at least one fenestration extends from at least one of the first and second channels to an outer surface of the bone fixation element.