Reflex Hammers Compared: Taylor, Queen Square, Babinski and Buck

Percussion hammers look interchangeable and are not. The differences are in mass, handle length and how the swing delivers force.

Taylor (tomahawk)

The triangular rubber head on a short flat handle. Compact, pockets easily, and the most commonly bought — particularly by students.

Weakness: the short handle means the swing comes from the wrist, and it is light. Eliciting a reliable response in a large or tense patient is harder than it should be, and reproducibility between attempts is poorer.

Queen Square

A disc head on a long, thin, flexible handle. The standard in neurology.

The long flexible handle lets the head swing under gravity with minimal wrist input, which is what makes the stimulus consistent from one attempt to the next. Reproducibility is the reason neurologists prefer it. The trade-off is that it does not fit a pocket.

Babinski

Similar disc head to the Queen Square, usually with a telescoping or detachable handle so it packs down. Often includes a retractable needle or brush in the handle for sensory and plantar testing.

A reasonable compromise if you want Queen Square behaviour in something portable.

Buck

A double-ended head — a broad face for large muscle groups and a pointed face for smaller tendons. Many include a brush and needle in the handle. Compact and versatile.

Which to buy

• Student or general ward use — a Taylor is fine and fits a pocket.
• Regular neurological examination — a Queen Square. The reproducibility genuinely matters.
• Travelling or home visits — a Babinski or Buck, for the packability and the built-in sensory tools.

Practical notes

Rubber perishes — a hardened head bounces rather than delivering force, and hurts. Replace it when it stiffens. Stainless handles can be wiped down between patients; wooden ones cannot be properly disinfected.

Hammers are in reflex hammers, with the wider range in neurological testing.

This article is part of our guide to Building Your Diagnostic Kit: A Guide for GPs and Clinics.

Browse the range in our diagnostic equipment collection.