I installed the game again to see if I had any issues and the game booted through the intro to the menu with no issues, no fixes applied.

Try lowering the "Detail" setting in the launcher & setting the "Screen Effects" to none. Maybe also un-tick Windowed Mode if you have that ticked.

In some rare cases where the game still crashes on Nvidia and AMD gpu's, the d3d9.dll file used to run the game on INTEL apu's can still help you run the game.

You can get it here: https://www.dll-files.com/d3d9.dll.html
Lemme know if it works or not.

In case this doesn't fix your problem, you could try to re-install the game OR verify/repair the game. It should work, so if it still doesn't work, im afraid your computer might be poorly optimized or incompatible with this game. As it works out of the box for 99% of people.

there are a lot of differnt files at that link, which one should I download?

I fixed the issue, which was that for some reaon the ggame was re writing tthe fallout.ini file to be almost blank, but downloading an ini off nexus, replacing falout ini with it and setting it to read only fixed the issue

Ok, sorry for not replying immediatly, but the d3d9.dll file was the one i meant. It's good you got it working.

Are you trying to play with mods enabled?

If you read what i wrote earlier you'll find the fix.
download the "d3d9.dll" file from anywhere online and put it in your main Fallout directory. Same folder as "Fallout3.exe"