apply very broadly, you have a good shot wherever will interview you, take step 2 early and do really well, get a good mentor in ortho that will speak for you, and get honors (or more importantly, work hard and get along well with residents and staff and make them want you in their program) in all your ortho rotations (including aways). the equation is the same as it is for all the other people that have 220s on step 1.