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Macrophages serve as pivotal coordinators within this cascade, with their polarisation from pro\u2010inflammatory M1 to proregenerative M2 phenotypes, which play a crucial role in determining the repair outcome. Emerging evidence underscores the significant influence of mechanical cues such as strain, stiffness, vibration, and scaffold topography on macrophage behaviour, thereby linking mechanobiology with immunology. This review summarises the current knowledge on mechano\u2010immunomodulation in fracture repair, emphasising how mechanotransduction pathways, including Piezo1, YAP\/TAZ, and PI3K\/AKT, affect macrophage polarisation and their interactions with mesenchymal stem cells, osteoblasts, and endothelial cells. This review examined biomaterial strategies that leverage mechanical properties ranging from ceramic scaffolds and calcium phosphate coatings to hydrogels and advanced magnetic\/electrical interfaces to shape the osteoimmune niche. Translational perspectives highlight mechanobiologics, immunometabolic reprogramming, and personalised loading regimens as next\u2010generation approaches for fracture care. The remaining challenges include context\u2010dependent macrophage responses, limited bone\u2010specific mechanosensing data, and the need for standardised models and regulatory\u2010compliant biomaterials. 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