All depends on if you have bonus ranged damage/ammo. I find I end up with tons of shotgun shells where .44 gets used up fast.
grease gun uses .45, nothing else does.
the tommygun is useless with its unique 6STR for smallguns, so basically, the only useful un that uses .45 ammo is the grease gun (critted for 340 damage on a rat(instagib, yay))
pretty much a waste of 1 SPECIAL attribute, personally, it's either 4 or 5 strength, 3 and 2 is far too little to carry necessary equipment, and I always use smallguns, ever since my total failure to get comfortable with energy weapons and bigguns, too little variation...