Orthopedic fastener

An orthopedic fastener comprising:

• a head;
• a shank, the shank extending from the head to a distal tip, the shank having a leading end portion adjacent the distal tip and a trailing end portion adjacent the head and an intermediate portion between the leading end portion and the trailing end portion, the intermediate portion having a first leading transition at the leading end portion and a second trailing transition at the trailing end portion, the intermediate portion having a larger diameter than the leading end portion;
• wherein the leading end portion has first threads extending adjacent the distal tip to at least the first leading transition, the intermediate portion has second threads extending from the first leading transition to at least the second trailing transition, and the trailing end portion has third threads extending from the second trailing transition toward the head, the leading end portion having one or more cutting grooves extending adjacent the distal tip through at least a portion of the first threads, the first leading transition having one or more cutting grooves extending adjacent the first threads to adjacent the second threads, the second trailing transition having one or more cutting grooves extending adjacent the second threads to adjacent the third threads;
• wherein the diameter of the second threads is 1.0 to 2.0 mm greater than the diameter of the first threads and/or the diameter of the third threads is 1.0 to 2.0 mm greater than the diameter of the second threads;
• wherein the first threads are double start threads and the third threads are double start threads;
• and
• wherein each thread start of the double start threads of the first threads are 180 degrees apart and/or each thread start of the double start threads of the third threads are 180 degrees apart.