An expansion and compression instrument (10) for fracture fixation. The instrument includes a first handle member (20), a second handle member (30), a bearing assembly (40), and a replaceable tip insert (50). The bearing assembly (40) axially receives a driver (60), such as a hexagonal head screwdriver. The replaceable tip insert (50) is adapted to engage an aperture (82) of a fracture fixation plate (80). The driver (60) is adapted to engage the head of a bone screw (91), partially threaded into bone proximate the fracture and disposed through a longitudinal slot of the plate. Manual manipulation of the handle members (20, 30) together or apart causes the driver head and replaceable tip insert (50) to become farther apart or closer together, respectively. This in turn, causes the bone screw (91) to be displaced along the longitudinal slot, expanding or compressing the fracture, respectively. Pivotal or hinged attachment of the bearing assembly (40) to a handle member (20) permits pivotal movement of the driver (60) relative to the handle member (20) and permits the jaws of the replaceable tip insert (50) to remain in substantial engagement with the fracture fixation plate (80) during expansion and compression.
