If you are really wanting to try for ortho and not ENT, I would recommend trying to get on a research project in ortho to at least be able to say that you've been participating in some research relating to ortho.

Get to know people, get into the OR with the residents, go to morning conferences. Find an ortho faculty mentor. Do ortho research. Now its about getting to know people and letting them know you want to do ortho. Yea we like smart people, but what we value more is people we can work with. I would rather have a hard worker instead of someone with a 250+ step score or someone that I knew would want to come to work early and stay late.