I apologize for just seeing this post, but I'm hoping my two cents may still benefit you.
My fiance and I were candidates similar to you and yours (my fiance actually had better scores and more research than yours), coming from an Ivy League med school. I was applying in Ortho and he was applying in Neurology. We applied broadly - I selected 49 programs across the country, handed him the list, and said that he needed to have one or more programs to go with each of mine. I don't want to imply that I wear the pants in our relationship (I don't!), but we were both very conscious of exactly how competitive Ortho is. I had almost 20 interviews at top-notch programs (Penn, Duke, NYU-HJD, WashU, etc.), and he had so many interviews he canceled at least half of them. Neuro is not very competitive, and he was told on almost every interview that he could name his dream program and go there. Being very conscious of how competitive Ortho is, as our very last choice on our rank list, I think it was #79, we put down a choice of him matching at a program where we knew he had a spot and me not matching. That is what we got.
My PD (who is now my boss - I'm doing a research year under him) feels that the Couples' Match is the only reason I didn't match last year. I have trouble believing that, since my "couple" is at his first choice (top Neuro program in the country!), but it may be that in the world of Ortho, the Couples' Match is just one extra variable that the system doesn't want to have to deal with. However, if I were you, I would be FAR more concerned over YOU holding your FIANCE back than the other way around (in the sense that if we hadn't put down that last choice, my fiance wouldn't have matched, either). Matching in Peds is almost a sure thing. Matching in Ortho is far from it.
Feel free to PM me if you have any other questions, or would like to know how we negotiated through making our rank list, etc. I would certainly like to use my experience to help others be better prepared.