Intended for healthcare professionals

Feature Christmas 2019: Let it Be

The hammer: instrument of Thor (and orthopaedic surgeons)

BMJ 2019; 367 doi: (Published 16 December 2019) Cite this as: BMJ 2019;367:l6648
  1. Hosam E Matar, arthroplasty fellow1,
  2. Peter Kay, professor1,
  3. Michael Morlock, professor2,
  4. Tim N Board, professor1
  1. 1Centre for Hip Surgery, Wrightington Hospital, Wigan, UK
  2. 2Technische Universität Hamburg, Hamburg, Germany
  1. Correspondence to: H E Matar hematar{at}

Hosam E Matar and colleagues examine the history of one of our oldest tools

The hammer is arguably the first tool lifted by prehistoric man, and despite advancing digital technology it remains an essential tool in many aspects of modern life. In parallel to the development of the human brain, the hammer evolved along myriad paths to appear in the tool boxes of many professions, from stonemasons and blacksmiths to astronauts. More importantly, however, hammers and mallets are essential tools for orthopaedic surgeons. We look at the science behind their development and longevity.


Geological artefacts suggest that hammers made of stones attached to sticks of wood were used as tools from before the Stone Age (fig 1).12 The Bronze Age introduced metal to toolmaking, when axes with bronze or copper heads attached to wooden handles appeared in Mesopotamia.3 By 200 BC iron headed hammers were being used in ancient Rome, and by AD 75 a Roman claw hammer with a striking surface on one side and a curved claw on the other was in use.4

Fig 1

Early hammer with a stone head and a wooden handle attached by a string made of animal leather

Many variations on this basic design have since evolved to serve different purposes, from the industrial to the artistic. It is unclear when medical hammers were first used, but one of the first percussion hammers was designed and popularised by the German physicist Max Wintrich in 1841 (fig 2).5 Mallets look similar to hammers but typically have barrel shaped heads made of light and low mass materials such …

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