Complex sentence: The medal was physically identical in all realms where it was awarded, save for Canada, where it contained unique elements; as an internationally distributed award, the Queen Elizabeth II Silver Jubilee Medal holds a different place in each country's order of precedence for honours.
Split into simpler sentences: The medal was physically identical in all realms where it was awarded, save for Canada, where it contained unique elements. As an internationally distributed award, the Queen Elizabeth II Silver Jubilee Medal holds a different place in each country's order of precedence for honours.