Iron Fist is a straight damage bonus during unarmed attacks, and does not increase Unarmed skill points.
In the world of hand to hand fighting, the player can choose to max 3 levels of Iron Fist for a 15 point unarmed damage bonus, which can be especially powerful early on when combined with power fists (26+15=41dmg). Or the player can pursue the melee weapons route, which will save 3 perk slots, but be less powerful than unarmed combat until the level 12 Pyromaniac perk which turns the custom-built shortsword known as the Shishkebab into a powerhouse (60+3fire/5s).
However, Iron Fist can still pay off in late-game combat. With the use of a custom-builtdeathclaw gauntlet, the player can match the performance of the Shishkebab on many tough targets. Against deathclaws and power armored soldiers who average 45 DR or more, the Shishkebab does (33+2fire/5s) per strike. The armor piercing deathclaw gauntlet would do full damage (26+15=41dmg).
This higher base damage against armored opponents and comparable base damage against unarmored opponents is coupled with an incredible capacity to land critical hits due to the deathclaw gauntlet's x5 critical multiplier. It is quite easy to almost always land a critical hit with perks such as Ninja, Finesse, Survival Guru, etc.
Unarmed also pays off if the player takes the Paralyzing Palm perk, and the lowered critical hit rate from forgoing Ninja can be made up for if the player combines Grim Reaper's Sprint with Paralyzing Palm - allowing them to paralyze an opponent and kill another in one V.A.T.S. move, finishing with replenished AP.
Although listed as a Fallout 3 perk, Ranger Stella from The Fort in Fallout: New Vegas has all three ranks of this perk.