Abstract: A self-tapping, self-drilling cannulated screw, for orthopedic bone surgery, has tip, shank, threaded and head portions. The tip portion includes circumferentially spaced cutting points defining end surfaces which taper approximately 17.degree. relative to a perpendicular to the screw axis to butt the distal end of the cutting edge of a cutting flute. The cutting flutes are formed at circumferentially spaced positions about the screw adjacent the tip portion and, upon insertion of the screw, efficiently direct chips through the threaded portions and past the shank portion. Reverse cutting flutes are provided at the opposite end of the threaded portion for cutting and forming threads upon unthreading and hence removal of the screw from the bone when healed.