Trends in the incidence of rib and sternal fractures: A nationwide study of the global burden of disease database, 1990–2019

•Rib and sternal fractures present serious challenges to trauma clinicians and are associated with significant morbidity and mortality.•Overall, the age-standardised incidence rate of sternal and rib fractures in England was higher in males than females from 1990–2019.•An overall decrease in incidence rate was observed among males, whereas an overall increase in incidence rate was observed among females.•Variation in diagnostic and management strategies may account for the observed sex disparities and regional differences in incidence.•The increasing injury burden is suggestive of the importance of clear clinical guidance and sustained financial investment in trauma infrastructure. Fractures of the ribs and sternum are associated with significant morbidity and mortality. Characterization of the injury burden across England is necessary to inform and evaluate developments in trauma care and infrastructure, however is yet to be comprehensively undertaken. Therefore, the aim of this study was to describe trends in the incidence of sternal and rib fractures across England between 1990 and 2019. Age-standardised incidence rates (ASIRs) for rib and sternal fractures in males and females were extracted from the 2019 Global Burden of Disease (GBD) study by all causes, falls and road traffic collisions for 9 sub-regions of England. Temporal trends within the study period were analysed using Joinpoint regression analysis. The overall ASIRs in England in 2019 were 30.34/100,000 and 46.02/100,000 for females and males, respectively. Between 1990 and 2019, the estimated overall percentage change across England was +0.20 % among females and -7.05 % among males. A statistically significant increase in ASIR was observed in all 9 sub-regions of England among females from 2014–2019 (p