Adjustable length surgical screws and inserters for adjustable length surgical screws and methods of using the screws and inserters are provided. In general, a fixation device such as a surgical screw can be configured to have an adjustable length. The fixation device can have one or more break points along a longitudinal axis thereof. In an exemplary implementation, the fixation device can include a plurality of break points. The plurality of break points can be formed at different predetermined axial positions along the fixation devices longitudinal axis. The fixation device can be configured to break at each of its one or more break points, for example breaking along a plane that is substantially perpendicular to the longitudinal axis of the fixation device.