A cannulated headless compression screw is provided with an attachment mechanism that enables coupling various attachments to the headless compression screw. The headless compression screw includes a screw thread on its exterior that is adapted to effect compression between two bone fragments. For instance, the exterior screw thread may have a variable pitch formed to effect such compression. The interior of the headless compression screw's trailing end includes an interface that is adapted to engage with a driving instrument. A surgeon may drive the headless compression screw into bone via the driving instrument and then access the attachment mechanism to couple an attachment to the headless compression screw.