Haven't looked at this website in years. However, it's that time of year (I think it still works that way) when people like the above find out they didn't match. Actually I guess that was last month. Anyway, I've been there. I didn't match into ortho my first go around, and it was a complete shock. I had similar to the original poster, but apparently I'm not as smart because my board scores were not as high. The program directors where I rotated and at my home institution could not or would not tell me what the issue was. They were all surprised too. "Fell through the cracks" was a phrase they liked to use. That's pretty meaningless to someone who didn't match and wants to fix whatever went wrong. I did the prelim year, primarily because I couldn't find a decent research spot that would pay enough to support a family. I had a wife and three kids by that time. The prelim year didn't help me much other than I think it gave me a little leg up at the program I rotated at. I went to all the ortho rounds and such even though I was gen surg. I ended up ranking them lower and matched higher on my second time around so I don't know how they ranked me. I didn't accomplish any research that year, and frankly it's tough to realistically get papers out and published and on your CV by the time applications are due again. However, I'm sure some institutions can do it. Just check into that aspect before you invest just one year, or think about maybe two. A friend in the same prelim program had not matched into ortho twice in a row and that next year failed to match a third time. However, a new program spot opened up one month after he started general surgery residency and he is now a practicing orthopaedist. That's rare, but it's hopeful.
I'm about to start my Thursday clinic as a hand surgeon in a minute. Today the fact that I didn't match the first time around doesn't affect me or my practice. Maybe it just makes me appreciate what I have a little more. That and I suppose I could do a sentinel lymph node biopsy myself when I resect a melanoma from a finger if I really needed to thanks to that year of gen surg.
Press forward, work hard. Success is well within your reach.