The present application provides external bone and tissue fixation systems and related methods. The fixation systems may include an elongate beam element defining an axis with an axially extending threaded track portion. The systems may also include at least one drivable fixation clamp assembly comprising a housing with a central bore, a driving housing rotatably coupled to the housing, a threaded driving member, and a clamp assembly rotatably coupled to the housing configured to clamp to at least one fixation member. The elongate beam element may extend axially through central bore of the housing. The driving member may be movable with respect to the central bore via rotation of the driving housing between engaged and disengaged states with the threaded track portion. Rotation of the driving member in the engaged state may axially translate the clamp assembly along the beam element.