
As the person hasn't contacted with more details I will say that sometimes like with human babies the pup gets squashed in utero and the ligaments pulled so the pastern is turned on itself.
As long as the limb itself and the joint are not malformed, massaging into correct position several times a day, and constantly putting the foot in correct weight bearing position when pup at milk bar, will be curative if this is the problem.
Remember a pups bones are little more than cartilage.
I had this happen in a litter I bred long ago and the pup was fine, and recently heard of another breeder who had one like this, she kept hers and the pup is a fine healthy and sound 20 months old.
The vet in both cases predictably said wait and see offering no real advice.