Sorry for late reply. I am a PGY-1 in Ortho and my fiance is Peds PGY-1 at same program...we did the "couples" match. Since your wife is a strong candidate, by letting the programs know that you are couples matching, it will really help! Essentially what happens is that, being IM, your wife will get interviews sooner than you. When her programs pull her file, see you listed as a couple, they will then contact the orthopaedic program to discuss the matter at hand. And in most cases, especially if the two departments have a great rapport, the Ortho program will then look at your file. If you are a strong applicant too, then essentially you made life easier for them, allowing the hospital to get two great residents with little effort. Also, some programs even rank people coupling at the top of their list! A tip for you two (one that my fiance and I did), being IM, your wife will get interviews much sooner than you (ortho is more Oct-Nov), and as soon as she gets the email/contact to schedule her interview, in her reply, she needs to mention that she is coupling with you who is going for Ortho. My fiance did this, and many times, the next day, I would get an invitation to interview at the same program! And on our days of interviewing, we'd mention it again to the program directors...and often the directors would make note of it and say they would speak to the other program to see what her/my status was.
Good Luck!