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The notion of fractional fixed point is an extra complexity added recently by software mindset and their tools and imposed on fpga designers.
In fpga mindset you can use integer concept without any problem. fractional approach is just another mental perspective of location of an imaginary decimal point.
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This is very true. At an implementation level, if you forget about the fraction/interger parts then it is all just integer arithmatic.
But we need to monitor these two parts separately when you are doing performance checking of your algorithm/system, which is more important than just the FPGA design on its own.