Sorry about not matching, fortunately there are definitely still ways to get in to ortho. Even though you are in a different scenario than the other guy that posted with your scores, and already having done a research year, I think I would recommend doing another research year if you truly are set on doing ortho.

From that thread:
"I would 100% recommend doing a research year based on what I have heard/seen. By doing a prelim year you sort of pigeon-hole yourself in to that program and hope the ortho program there likes you. Also, your application essentially doesn't change by going the prelim route...other than one more person saying you work hard and you are now applying as having already graduated instead of a US Senior.

The research year will open doors at that program, and hopefully many others by bolstering your research stats and having the research doc make calls for you. You also can delay graduation from your school so you are still applying as a US Senior. Hopefully they will help you with interview answers stand out as well, since that probably played a part in not matching as well."

For what it's worth, I had a 221 step 1 and matched, also did a research year but killed it (20+ papers published). Even though you have already done one, I think it is still your best chance to do ortho but you need to find a killer research year with someone who will go to bat for you and make calls to other programs.

As far as your questions, I know people who didn't match 3 times and then eventually got ortho...so it's always possible. I don't know anything about prelim years

I'm going to go the other way. Been there done that, and I would recommend the Prelim route. That being said, you have to pick the right program. When I was interviewing the programs, I asked them, how you going to help me get an orthopaedic spot? Are you going to set me up with the Ortho PD at your program? Is there a rotation available with the Orthopedic surface? Does your program have a track record getting prelim interns into Ortho spots?

Either routes are options. You have research, what is a couple of more articles in six months going to accomplish when you already have multiple for an entire year? The prelim route also gives you the opportunity to jump into a spot midyear should that occur, or jump into a PGY 2 spot should one become available at next round of interviews, which there usually is one somewhere in the country every year. I know people who have filled those scenarios multiple times. Research year places you as an MS4 pretty much.

All that being said, you need to bust your hump where ever you go. Whether you do research or prelim, go to the Ortho grand rounds weekly. Go volunteer in the Ortho clinic. Take ortho call. Start building relationships and lobbying for yourself.

So pick what you think is best for you and going to help you get where you need to be. Good luck.

Schatzker makes good points. If you go the prelim route definitely do those things to ensure you are giving yourself the best possible chance at that orthopedic department. Would also probably be wise to contact the ortho departments there to see if they would even consider you after a prelim there. Regardless, you 100% have to bust your butt wherever you go.

I guess the one thing that I still favor over doing a research year again is 1) you get another chance at applying as an MS4 and not as an independent, you can't go back to that once you enter a prelim. You can always do the prelim year if you don't match a second time. You can also do a research year after a prelim year (have heard of this happening and someone matching).

Good luck man, I think either option is a feasible way in to ortho, just need to decide what you think gives you the best shot.