Implementations described herein include a bone cement mixing and delivery device including a cylindrical container defines a chamber and has an injection passage disposed at the distal end thereof. A plug can be removably disposable in the injection passage. The mixing screw is rotatably disposable in the chamber and has a screw thread extending along an outer surface of the mixing screw as well as a return passage extending through the mixing screw from the proximal end to the distal end thereof. In a mixing mode of the device, a mixing rod engages and rotates the mixing screw about the longitudinal axis of the cylindrical container causing material disposed in the chamber to be moved distally and return to the proximal end of the chamber through the return passage of the mixing screw. In an injection mode of the device, the plug can be removed from the injection passage and an injection rod occludes the return passage of the mixing screw. The injection rod engages and rotates the mixing screw about the longitudinal axis moving material disposed in the chamber through the injection passage.