A bone fixation element includes a distal end defining a longitudinal axis and being configured to penetrate tissue, a proximal end defining an axial opening disposed in communication with a transverse passageway and a fastener including a proximal portion having spaced apart walls that define an implant cavity and a distal portion disposed with the transverse passageway and configured to penetrate tissue. The distal end is disposable in spaced apart relation to the distal portion of the fastener within tissue. Methods of use are disclosed.
