Both will be fairly high on my rank list.

K-Zoo: Pros: Strong didactics, very structured clinics, one of the best life-styles you will come across (home call five years), good variety of elective bread and butter ortho. Several fellows in every specialty exclusing tumor, although I am not sure about foot and ankle. Six months of the year, you will be in one of the nicest hospitals in the country. Outstanding benefits.

Cons: Only two residents per year means that you take a lot of home call over the years, a little light on trauma, a little too much clinic for my taste (I know I had the organization as a plus, but the volume is a minus) city isn't the greatest.

Grand Rapids: Pros: Great mix of tertiary care referral center and small private hospital, 40+ fellow trained guys in everthing but tumor, trauma up the wazoo, but nice life at the small community hospitals, huge volume or bread and butter ortho, great city for its size, probably the tightest group of residents I have seen on the trail. Not too much clinic you become an operating machine. Outstanding benefits.

Cons: Peds is up in the air right now. They have had an interim chair going on three years. Clinics are pretty crazy, you don't get much for continuity. You don't get to see a lot of scope work until you 4 or 5.

Head-to-head: I think Kzoo has a little better didactic program, definitely a better lifestyle, a better outpatient surgery experience, and a little more stable. Grand Rapids has a much higher volume, better trauma, a better city, and more in flux, both at the top and in their peds.

This is about as cerebral as I can be on this one. They are both strong programs, so I don't think you could go wrong with either. My list has been in for about 3 weeks and I just went with my post interview gut feeling, but that would have been my pro and con list had I tried to go that way.

Well as a resident at kalamazoo i can only speak for our program. I did not interview at grand rapids (schedule conflicts).
First, let me tell you that I think we do plenty of trauma. ANd i come from a med school that does A LOT of trauma (actually too much) Now, we dont get the kind of penetrating stuff that a big city will, but that is mostly food for general surgeons in my opinion. There are plenty of car wreck/multiple extremity trauma cases as we are located on the main highway that runs between chicago and detroit, so there is a lot of traffic in our neighborhood.
Second, the lifestyle thing is definatly a plus. While having home call all the time may sound weak, during the busy times it basically means you have a chance to go home and eat dinner with your wife before going back in. Other times you throw a no hitter (not in the summer though!) Also, you wont find one resident here that does not love it and has any regrets about coming here. As far as the clinic thing goes, the amount of clinic you do varies by your year and the hospital you are at. Thats funny you say that, b/c some of the applicants this year asked if i felt we got enough clinic time?? Certainly not as much as mayo, where it is every other day (of course they are the mayo CLINIC)
Last, as far as fellowships and attendings we do have all the bases covered ex tumor, and recently the foot guy retired early for medical reasons. We have two joint guys that did their fellowship at harvard, several sports guys who take care of the local university, spine(if thats your thing) and one of the chiefs from this year is coming back (after doing his trauma fellowship at carolinas med center) and hand.
Those pluses being said, this is not the place to go if research is your thing. It is just not a focus here (which i find a plus, but others may not)
From what i hear of Grand Rapids, i think anyone would be happy at either program and get trained well. Good luck guys, this time b/t the rank list is in and match day seriously sucks. I dont envy you!