yes i am female. my step one was in the same range as yours, but when i decided on ortho, (late, i was grooming myself for primary care or ER) i busted my ass on step 2, did 2 away ortho rotations and honored them, did a home ortho rotation sub-I and honored it and started trying to network within my home ortho program. i got strong letters of recommendation. i also got a faculty advisor or two, started getting involved with the research that goes on here early in my 4th year and went to as many grand rounds, journal clubs, lectures as i could. basically i wanted to show people i was serious and interested.
as far as an interesting application ... well, that's just an individualized thing. my path to medschool wasn't typical and my activities during medschool weren't typical of what most programs tend to see (at least that's what i've been told in all my interviews.) i'm not going to babble on about what i've done, but when it comes down to it, i'm secure in my application and can explain well all of my "ortho deficiencies." i also can explain very well what has drawn me to ortho and why i want to do it. everyone will ask you that.
bottom line is if you decide it's something you want to do, with a sub-220 score, you need to start busting your butt to show your interest. you can get interviews, but be prepared to explain the 'why ortho' question and discuss the aspects of your application that are different or 'deficient' with confidence.