A bone fixation apparatus includes an insert and a bone anchor. The insert has open ends defining a lumen. A first thread is disposed on an outer surface of the insert and a second thread is disposed in the lumen. The insert is configured for threadably engaging bone. A driving tool is releasably attachable to the insert. The bone fixation apparatus also includes a bone anchor with a bone screw member and a housing. The bone screw member extends from the housing and has a third thread along a shank of the bone screw member. The third thread of the shank is engageable with the second thread of the lumen such that the bone anchor is coupled to the insert.