So, progress has been made, but Im not quite there yet...
I edited the "Awardsitems 3&4" files.
I pasted every italian medal over the respective german one it should replace.
I tested this, after giving myself every medal by editing the savegame, but in the Awards-screen, the american medal wich is in "awardsitems 2" on the right hand side would show up

So I switched around the numbers of the files inside the menu_1024_768 file,
basically making every "awarditems 1" into a 3, every 2 into a 4 and vice versa...
When I did this, the "croce di guerra" showed up, the replacement for the german "knights cross" that sits in "awardsitems 4" on the right hand side.
Why this works is beyond me, since its basically loading a texture out of a foreign file...
Yay, an italian medal! Trouble is, it showed up for every single medal
Here is the awards-section of my menu_1024_768 file
Mat 0=data/menu/data/awardsitems_4.dds
Crop 0=0.5,0.0742188,0.5,0.851563
Mat 1=data/menu/data/awardsitems_3.dds
Crop 1=0.5,0.0742188,0.25,0.851563
Mat 2=data/menu/data/awardsitems_3.dds
Crop 2=0.75,0.0742188,0.25,0.851563
Mat 3=data/menu/data/awardsitems_4.dds
Crop 3=0,0.0742188,0.5,0.851563
Mat 4=data/menu/data/awardsitems_3.dds
Crop 4=0.25,0.0742188,0.25,0.851563
Mat 5=data/menu/data/awardsitems_3.dds
Crop 5=0,0.0742188,0.25,0.851563
Mat 6=data/menu/data/awardsitems_1.dds
Crop 6=0.25,0.0742188,0.25,0.851563
Mat 7=data/menu/data/awardsitems_1.dds
Crop 7=0.5,0.0742188,0.25,0.851563
Mat 8=data/menu/data/awardsitems_1.dds
Crop 8=0,0.0742188,0.25,0.851563
Mat 9=data/menu/data/awardsitems_1.dds
Crop 9=0.75,0.0742188,0.25,0.851563
Mat 10=data/menu/data/awardsitems_2.dds
Crop 10=0,0.0742188,0.5,0.851563
Mat 11=data/menu/data/awardsitems_2.dds
Crop 11=0.5,0.0742188,0.5,0.851563
And here are are the Awarditems 3 and 4 files respectively:
Any assistance would be highly appreciated