Composite material screws and construction techniques are described comprising reinforcing fibers directed in different winding directions and/or angles at different layers (radial depths) of the screw. Optionally, the screw comprises composite material layers wound with fibers at both the pitch of the thread of the screw and at a steeper pitch (for example, about 45°). Optionally, an outer layer of the screw comprises a relative radiolucent construction and/or material, with a more radiopaque construction and/or material positioned underneath the outer layer such that at least a portion of the screw outline is delineated by a radioimaging technique (for example, fluoroscopy, CT, or MRI), while maintaining a sufficiently artifact-free image around the screw that the image characteristics of the surrounding tissue are still determinable.
