The invention provides a medical screwdriver having a sleeve that can be coupled to the medical screwdriver without the need to align the sleeve to the medical screwdriver. The medical screwdriver includes a body portion having a receiver, a drive shaft, a sleeve, and a coupling connecting the sleeve to the receiver. The sleeve surrounds at least a portion of the drive shaft when coupled to the receiver. The coupling comprises an end of the sleeve and the receiver of the body portion. The end of the sleeve and the receiver are designed so that the end of the sleeve can be coupled with the receiver of the body portion without rotationally aligning the end of the sleeve to the receiver of the body portion and so that the sleeve is prevented from rotating in a direction of rotation during use.