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.