Abstract: [Objective] To compare the clinical outcomes of hybrid versus double rod fixations with bridging combined fixation system for distal femoral fractures. [Methods] A retrospective study was conducted on 36 patients who received open reduction and internal fixation with bridging combined fixation system for distal femoral fractures in our hospital from January 2018 to December 2020. Among them, 17 patients had fractures fastened with hybrid fixation (HF), while the remaining 19 patients were with double-rod fixation (DRF). The perioperative, follow-up and imaging data were compared between the two groups. [Results] All patients in both groups had operation completed successfully without serious complications. The HF group proved significantly superior to the DRF group in term of operation time and incision length (P<0.05). However, there was no significant difference in intraoperative blood loss, number of intraoperative fluoroscopy, postoperative drainage volume, wound healing and hospital stay between the two groups (P>0.05). All the patients in both groups were followed up for more than 12 months. The HF group resumed walking and full weight-bearing activity significantly earlier than the DRF group (P<0.05). The knee extension-flexion range of motion (ROM), HSS score and Schatzker and Lambert’s criteria increased significantly over time in both groups (P<0.05). At the corresponding postoperative time point, there was no significant difference in ROM between the two groups (P>0.05). At 1 month after operation, HF group was significantly better than the DRF group in term of HSS score (P<0.05). At 1 month after operation, HF group was significantly better than the DRF group in term of HSS score (P<0.05). At 6 months and the last follow-up, the Schatzker and Lambert’s criteria of HF group was better than that of DRF group (P<0.05). Radiographically, there were no significant differences in fracture reduction quality and fracture healing between the two groups (P<0.05). However, the HF group got FTA angle on images significantly lower than the DRF group (P<0.05). [Conclusion] Compared with the double-rod fixation of the bridging combined fixation system, the hybrid fixation can not only achieve stable fixation in treatment of distal femoral fractures, but also effectively avoid the varus deformity of distal femur, and is more conducive to comminuted fractures.