A ratcheting compression device is provided which is very strong, which can be customized in length, which can be retightened periodically to maintain compression, which allows precise placement and alignment of bones with both grossly tuned compression and finely tuned compression, and in which only a limited inventory of parts is required. The two-piece compression device comprises (a) a novel first piece having a bone screw located at a first end thereof and having a ratcheting member located near the second end thereof and comprising teeth having their crests lying substantially in a plane and (b) a novel second piece comprising an anti-rotation member which acts in cooperation with the ratcheting member of the first piece to compress two segments of bone together. In yet other embodiments, two embodiments of a driver are provided for quickly driving the stop onto the ratcheting member to a desired extent. In a further embodiment, a customized method for compressing and fixing a first bone segment and a second bone segment together is provided.