If I were you, I would go through every single Ortho residency program available and make a list of those friendly to IMGs. Take a look at every single website and if they, by some chance, take IMGs and do not have a score cut off (this is highly unlikely), then put it on the list. I would try to find 10 programs like this in ortho. Also consult match stats from last year and see if any ortho programs didn't fill, but I don't think you'll find much there.

Make 2 personal statements, one geared towards Ortho and one Psych (Family Medicine could work too, but I'm going to be honest, you have a much better chance at Psych so I'm going to suggest that). Rock the hell out of those personal statements and make it seem like you live and breathe Ortho in one and Psych in the other.

You're in a tough situation that you haven't been through an Ortho rotation yet, so you won't be able to get an ortho-centered LOR. Go back to anyone who would be willing to give you a STELLAR LOR and explain your situation to them. Let a few of them know that you want 2 letters, one ortho geared and one psych geared. I don't know how valuable it will be because you haven't worked with anyone in the ortho field, but maybe they'd be able to mention that you have an aptitude for that area. Make sure you get just incredible LORs, don't ask anyone who doesn't think really highly of you, or who will at least pretend they do for the letter.

So apply to those 10 ortho and then apply to every psych program you can afford. Go through every single website and find all information you can, IMG status and step score cutoffs. Psych is very forgiving here. You're at the point where you need to decide if you are okay with doing psych or nothing.