An orthopedic fixation assembly for connecting to a bone includes a fixation plate having a hole, an insert securable to the hole and a screw securable to the insert. The fixation plate includes a shoulder recessed from its upper surface and an aperture. The insert includes a base portion and a flange extending laterally from an upper end of the base portion. The insert defines an insert central axis extending in a direction generally perpendicular to the flange. The screw has a screw head and the base portion has an insert hole with machined internal threads for engaging the screw. The insert hole defines an insert hole central axis extending in a direction at an offset angle relative to the insert central axis. The aperture of the fixation plate is dimensioned to receive the base portion of the insert and the recessed shoulder is dimensioned to receive the flange.
