I'd have to agree that you should take the time to read through the application part of the website for the programs you are applying to. It is time consuming and less than stimulating, but it is really worth it if you are truly set on getting into ortho. Investing a few hours here is really not that big of a deal, and it sure beats not matching.
Most programs do the standard three to four letters thing, but make sure you go to their website or call their office if the website is unclear. In general those are expected to be three letters from orthopaedic surgeons with whom you have worked. If there is an attending outside orthopaedics who knows you very well and can give you a great letter of recomendation you should weigh that in. However, I'd make sure from each program's website or by calling them that they don't specifically state "from orthopaedic surgeons" before you throw that letter in there. Also, you don't have to send the same letters to every program. You can get 10 letters of rec if you want from phsychiatry to OB/GYN and designate which letters go to each program. Just make sure you at least have the letters they specifically state they want. I'd say to error on the side of ortho attendings since that shows you've spent enough time with ortho to know you really do want to go into it. Ortho attendings have a much better idea of wether you'll make a good orthopod than internal medicine attendings, and they can express that better to fellow orthopods in a letter.
As far as the 5 hours of uninterupted sleep stuff, it's just a proposal at this point. I don't know much about it, but from what I've heard it is at the early stages at best and will likely not become a policy at all. Current changes in the healthcare system may prevent departments from giving up anymore cheap labor from residents as they start watching their reimbursements diminish. It's hard enough for many programs just to meet the 80 work week.