Getting a fellowship is more about "who knows who" rather than a numbers game. They would be much more interested in your OITE scores if they crunch numbers for applicants.

Step 2 will be unlikely to have any impact on obtaining a fellowship. My thought on Step 2 is that no one should blow it off until they know they will or have matched into orthopaedic surgery. If you dont match, you would hate to be reapplying with a poor step 2. With the exception of that situation which admittedly would affect very few people, your step 2 score will probably not matter much. Study as much as you can, but dont develop an ulcer over it like we all do with Step 1.

Took step 2 last week. Actually harder than I thought it would be. I was doing well on UW (75%) and took NBME test 3 and did well. I guess I'll have to wait and see.

by UW I assume you mean USMLE world? did you get 75% by doing real, timed blocks of randomized questions? The best I seem to be able to do is 65%. I took the NBME practice test and did ok ( a little lower than my step 1). I am just going to take it. I have been studying sort of on and off, but nowhere near the intensity of step 1.

I did not do timed blocks but did do random questions. My scores started around 60% and slowly moved up. I found that if i did timed blocks that I was too tired at the end to read all the explanations.

Do any schools require Step II before they rank you?

and how bad would it look if you had a big drop from Step 1 score? (I'm not automatically reporting the score on ERAS)

Duke does and I think one of the UC schools does. There may be more and it seems to be the trend that more and more schools are requiring it.

UCSF, as an institution, just started requiring passing Step 2 CK and CS scores to rank. Duke will rank you without your scores, but requires your passing scores be sent to them by May 31.