A fixation assembly having a driver, a holding sleeve, and an alignment mechanism is disclosed. The driver may include a driver body and a coupling extending from a distal end of the driver body. The holding sleeve may have a holding sleeve body, a channel extending through the holding sleeve body, and a fixation element coupler disposed at a distal portion of the holding sleeve body. The channel may be configured to receive the driver, and the fixation element coupler may be configured to temporarily hold a fixation element. The alignment mechanism may extend from the holding sleeve, and may have at least one alignment member configured to engage an underlying structure to which the fixation element is to be affixed so as to align the fixation element and driver assembly with respect to the underlying structure.