For what it's worth, I have a similar story to you.
Decided on ortho late, tiny school without a ton of infrastructure to give ortho guidance, no strong contacts in ortho to speak of, STEP 1 below the 2016 average for ortho, late on the ortho research train, etc, etc. Was asking this same question a year ago, deliberating and laboring over this 'Should I go for it, should I not, and if I do, how the heck do I even start choosing aways considering my STEP 1 didn't blow anyone's face off' decision.
Some kind soul suggested I look into a research year, and because I was willing to do at least one prelim year if it meant eventually matching ortho, I figured I may as well pay that year up front before I graduated than enter the fray that is trying to match out of the prelim pool. I ended up getting a position, so I took 5 weeks to lock down a solid STEP 2 score immediately after 3rd year, then started as a research fellow.
I've met with the PD here a few times, and been told multiple times that this was the right decision to make because:
1. The hard facts are, 230-240 may get you some interviews but it won't make the screen cut at a lot of places. This means contacts become a BIG DEAL. The likelihood you'll match somewhere you rotate is high to begin with, but if your STEP 1 is below average, it's way higher.
2. If you're working under an attending that has contacts (or, even if you're not directly under them but reach out and ask them if you can work with them that year), and they see you remain constant and reliable over a year, it goes far. Both for your chances at that program, and for letters.
3. You have time to look at orthopedics, make sure you're really set to grind out this road (That's harder than most, but not futile), and create a plan of attack as far as aways, letters, and 4th year scheduling.
4. Pubs never hurt
I'd recommend it for a few more reasons, but again, just my two cents based on how my story has gone. I'm happy to give more details if you want.
Good luck my friend!
