Score 2: partial exposure of glans, prepuce (not congenital adhesions) limiting factor. Score 3: partial retraction, meatus just visible. Score 4: slight retraction, but some distance between tip and glans, i.e. neither meatus nor glans can be exposed. Score 5: absolutely no retraction of the foreskin. Cause
There are three mechanical conditions that prevent foreskin retraction:

The tip of the foreskin is too narrow to pass over the glans penis. This is normal in children and adolescents. The inner surface of the foreskin is fused with the glans penis. This is normal in children and adolescents but abnormal in adults. The frenulum is too short to allow complete retraction of the foreskin (a condition called frenulum breve).Pathological phimosis (as opposed to the natural non-retractability of the foreskin in childhood) is rare, and the causes are varied. Some cases may arise from balanitis (inflammation of the glans penis).Lichen sclerosus et atrophicus (thought to be the same condition as balanitis xerotica obliterans) is regarded as a common (or even the main) cause of pathological phimosis. This is a skin condition of unknown origin that causes a whitish ring of indurated tissue (a cicatrix) to form near the tip of the prepuce. This inelastic tissue prevents retraction.
Bones
The skeleton of the human hand consists of 27 bones: the eight short carpal bones of the wrist are organized into a proximal row (scaphoid, lunate, triquetral and pisiform) which articulates with the bones of the forearm, and a distal row (trapezium, trapezoid, capitate and hamate), which articulates with the bases of the five metacarpal bones of the hand. The heads of the metacarpals will each in turn articulate with the bases of the proximal phalanx of the fingers and thumb. These articulations with the fingers are the metacarpophalangeal joints known as the knuckles. At the palmar aspect of the first metacarpophalangeal joints are small, almost spherical bones called the sesamoid bones. The fourteen phalanges make up the fingers and thumb, and are numbered I-V (thumb to little finger) when the hand is viewed from an anatomical position (palm up). The four fingers each consist of three phalanx bones: proximal, middle, and distal. The thumb only consists of a proximal and distal phalanx. Together with the phalanges of the fingers and thumb these metacarpal bones form five rays or poly-articulated chains. Because supination and pronation (rotation about the axis of the forearm) are added to the two axes of movements of the wrist, the ulna and radius are sometimes considered part of the skeleton of the hand.