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Ho hum just your average run of the mill med student at a top 5 school with a first author pub in Nature. But in all seriousness what would you do differently? Yes more ortho pubs will help. Excelling in clinica grades and step 2 is definitely going to be important, which you already knew. But you are clearly gifted and have a strong CV. have you tried meeting with the career planning office at your school? What did they tell you? You’re at a top5 program so if they know you want ortho they are going to help you get there.
 
I think it's fine to explore your options, but given that you "need" ortho research to match, I would say if you have any interest in it to just see if you could jump on a project with someone just to get your foot in the door and meet some people. This kind of stuff will be even more important since (I'm assuming) step will be P/F for you. Applying to the ultra-competitive specialties is definitely easier when you're playing the long game.
 
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