Even if you don't plan on ranking your home program highly (or not at all) many other programs will want to see a "Chairman's Letter" as one of your required LOR's. Unless you are a super stud, or your home program is very small, this is usually a very non-personal "stamp of approval" by your program's chairman to say that you would do a decent job as a resident. I'm not sure how all program chairmen would react, but I'm sure there may be some that may want you to do a month at your home program before giving you that "stamp" of approval. It is pretty standard, by my experience, to do a home rotation. I think you would be well served to find a month to do at home and "play by the rules", rather than buck the trend and risk not matching. You may be fine, and I'm sure there are plenty of people who have matched without doing a home month (there are many at med schools with no ortho programs), but I would suck it up and do the month, if nothing else, for the letter. Just my two cents.